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Pulmonary Actinomycosis as the Masquerader of Pulmonary Tuberculosis in a Young Male With Achalasia Cardia

Wani, Abdul Majid MD*; Zayyani, Najah Rashid MD*; Hussain, Waleed Mohd MD; Alharbi, Zeyad S. MBBS; Khoujah, Amer M. MBBS; Binhussein, Mohammad Ibrahim MBBS; Dairi, Mohammad Saleh MBBS; Akhtar, Mubeena MBBS; Hemdi, Mohanand MBBS; Al Miamini, Wail MD

Infectious Diseases in Clinical Practice: July 2011 - Volume 19 - Issue 4 - p 291-292
doi: 10.1097/IPC.0b013e3182002e1c
Case Reports

Pulmonary infections range from acute pneumonia due to various bacteria and viruses to chronic infections due to mycobacterium tuberculosis and various fungi. Anaerobic gram-positive, nonspore-forming bacteria of the genus Actinomyces that affects the oropharynx, digestive tract, and genitalia cause the infection known as actinomycosis. Thoracic actinomycosis may affect the respiratory tract and the pleura, even extending to the chest wall. Pulmonary actinomycosis occurs in immunocompetent persons during the fourth and fifth decades of life, with prevalence in men and is generally due to Actinomyces israelii or A. meyeri. It is frequently misdiagnosed as primary or metastatic lung cancer or tuberculosis. The accepted predisposing factors for bronchopulmonary actinomycosis are poor dental hygiene, alcoholism and various chronic debilitating diseases, hiatus hernia, and gastroesophageal reflux. We are presenting an interesting case of pulmonary actinomycosis presenting with hemoptysis, associated with achalasia cardia and treated as tuberculosis.

From the *Bahrain Specialist Hospital, Juffair Bahrain; †Hera General Hospital and ‡Umm Al Qurah University, Makkah, Saudi Arabia.

Correspondence to: Abdul Majid Wani, MD, Bahrain Specialist Hospital, Bahrain. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2011 Lippincott Williams & Wilkins, Inc.