Pulmonary actinomycosis is a rare chronic purulent granulomatous disease, which can be easily misdiagnosed as lung cancer, tuberculosis, and other diseases. However, diagnosis relies on histopathological evidence, and early diagnosis is conducive to the patient\'s recovery. In this study, a case of a 70-year-old man with a soft tissue density mass at the right lower lung was studied, with initial chest CT suggesting lung cancer, pulmonary actinomycosis was confirmed by subsequent pathological biopsy of lung tissues eventually. The patient responded well to antibiotics treatment. This paper is to explore the clinical characteristics of the disease, providing insight into the disease, and its diagnosis and treatment.

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BACKGROUND: The combined infection of actinomyces odontolyticus sepsis and cryptococcal encephalitis is rare in routine clinical practice. Thus, we presented this case report and literature review to provide clues to improve such patients\' diagnoses and treatment processes.
METHODS: The main clinical manifestations of the patient were high fever and intracranial hypertension. Then, we completed the routine cerebrospinal fluid examination, biochemical detection, cytological examination, bacterial culture, and India ink staining. Firstly, the blood culture suggested actinomyces odontolyticus infection, considering the possibility of actinomyces odontolyticus sepsis and intracranial actinomyces odontolyticus infection. Accordingly, the patient was administered penicillin for treatment. Although the fever was slightly relieved, the symptoms of intracranial hypertension did not relieve. After 7 days, the characteristics of brain magnetic resonance imaging and the results of pathogenic metagenomics sequencing and cryptococcal capsular polysaccharide antigen suggested that cryptococcal infection. Based on the above results, the patient was diagnosed with a combined infection of cryptococcal meningoencephalitis and actinomyces odontolyticus sepsis. Anti-infection therapy with \'penicillin, amphotericin, and fluconazole\' was provided, improving the clinical manifestations and objective indexes.
CONCLUSIONS: The combined infection of Actinomyces odontolyticus sepsis and cryptococcal encephalitis is first reported in this case report, and combined antibiotics with \'penicillin, amphotericin, and fluconazole\' are effective.

Pulmonary actinomycosis (PA) is an uncommon, asymptomatic, and frequently misdiagnosed pulmonary infectious illness. Our patient remained undiagnosed despite extensive regular and invasive testing, significant intermittent hemoptysis, and repeated bronchial artery embolization. Ultimately, a left lower lobectomy was performed via video-assisted thoracoscopic surgery, and a histopathological examination revealed an actinomycete infection.

UNASSIGNED: Pulmonary actinomycosis is an uncommon kind of bacterial illness caused by actinomycetes, involving the chest wall in extraordinarily rare cases. Due to non-specific clinical signs and perplexing radiological characteristics, this kind of pulmonary actinomycosis is frequently misinterpreted as a malignant tumor or lung abscess.
UNASSIGNED: An 11-year-old child presented with a palpable lump on his left chest and periodic chest discomfort. An irregular soft-tissue mass in the left upper zone with bony destruction was first identified as a malignant small round cell tumor (MSRCT) known as an Askin tumor on post-contrast CT. However, pathological biopsy of the pulmonary lesion through the chest wall revealed actinomycosis.
UNASSIGNED: Pulmonary actinomycosis is an uncommon bacterial illness that has a variety of clinical manifestations, particularly in young patients. A chest lump with nearby \"lace-like\" rib bone destruction was the distinguishing characteristic of our case. For appropriate treatment and diagnosis, infection with actinomycosis should be considered when observing a similar chest lump. Pathological biopsy, as a valuable diagnostic tool, can help to distinguish between infectious diseases and thoracic tumors. The pathological manifestations of actinomycosis are characterized by inflammatory lesions that range from purulent to granuloma-like inflammatory processes, and second-generation sequencing of alveolar lavage fluid can help to confirm pathogens.

BACKGROUND: Primary pulmonary invasive mucinous adenocarcinoma is a rare and distinct subtype of lung adenocarcinoma.
METHODS: A 72-year-old woman presented with productive cough for two months and fever for six days. Chest computed tomography (CT) showed a mass in the left lower lobe. Sputum culture tested negative for bacteria, but the sequence of Actinomyces meyeri was detected by metagenomic next generation sequencing from the bronchoalveolar lavage fluid. It was considered a pathogenic bacterium as the normalized number of DNA sequencing reads was 10 times higher than the normal level. The patient\'s symptoms alleviated quickly, and the chest CT lesion shrank to a third of the original size following treatment with penicillin for two months. However, a repeat chest CT performed after four months of treatment revealed that the lesion had expanded. Positron emission tomography/CT revealed that fluorodeoxyglucose metabolism was increased in the mass with surrounding ground glass density of the left lower lobe. Furthermore, CT-guided percutaneous lung biopsy was performed, and hematoxylin-eosin staining showed columnar tumor cells with abundant mucin in the cytoplasm with a basal nucleus. Finally, the patient was diagnosed with pulmonary invasive mucinous adenocarcinoma and agreed to undergo a thoracoscopic surgery.
CONCLUSIONS: Pulmonary invasive mucinous adenocarcinoma is a subset of lung adenocarcinoma with low incidence rate. The clinical features and CT findings are non-specific. A histopathological diagnosis is of fundamental importance in preventing misdiagnosis.

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This article reported a case of a middle-aged man with a 1-year history of intermittent cough and production of bloody sputum. Serum autoantibodies of the patient were negative. Early in the course of the disease, chest computed tomography (CT) scans showed a nodule in the right middle lung lobe with cavity formation. Surgical resection of the lesion was done with a postoperative pathological diagnosis of inflammatory pseudotumor. No treatment was given and his symptoms recurred with new patches in the right upper lobe. Pathology consultation from another hospital found vasculitis under the microscope and a diagnosis of granulomatosis with polyangiitis was made. His symptoms still worsened after glucocorticoid therapy. Final pathological consultation from Peking Union Medical College Hospital reached a diagnosis of pulmonary actinomycosis. Pulmonary lesions were absorbed after anti-infection treatment. The diagnosis and treatment of this patient provided more data for understanding of the relationship between infection and vasculitis among clinicians and pathologists.
本文报道1例中年男性患者，主因“间断咳嗽、咳痰、痰中带血1年”就诊。患者血清自身抗体阴性。病程初期于外院查胸部CT可见右肺中叶结节伴空洞形成，行手术切除病灶，术后病理诊断炎性假瘤，未予治疗后症状再发，复查胸部CT新见右肺上叶斑片实变影，上级医院会诊手术病理见血管炎改变，考虑诊断肉芽肿性多血管炎，加用激素治疗后病情仍逐渐进展，北京协和医院会诊病理诊断肺放线菌病，经抗感染治疗后病灶吸收。本患者的诊治过程加深了临床医师及病理科医师对感染与血管炎关系的理解。.