CHRONIC MIXED ACTINOMYCES ISRAELII AND HAEMOPHILUS (ACTINOBACILLUS) ACTINOMYCETEMCOMITANS INFECTION INVOLVING LUNG, P
CHRONIC MIXED ACTINOMYCES ISRAELII AND HAEMOPHILUS (ACTINOBACILLUS) ACTINOMYCETEMCOMITANS INFECTION INVOLVING LUNG, PLEURA, CHEST WALL AND BACK MUSCULATURE.
TREATMENT AND FOLLOW UP:
The patient was taken to surgery, and the thoracic and soft tissue components of the infection were debrided, and the patient was discharged on a 4-6 week course of IV ampicillin. Due to an allergic reaction, the patient was switched to ceftriaxone. He was seen four weeks post-operatively and had complete resolution of his physical findings and systemic symptoms. The plan was to continue IV antibiotic therapy, and then switch to an oral course of approximately one year.
Actinomyces species are slow-growing gram-positive filamentous rod with a tendency to grow in mycelial masses resembling sunbursts, (sulfur granules). These characteristics gave rise to the name actinomyces, meaning "ray fungus," a misnomer resulting from the filamentous nature of the organism. Actinomyces israelii, the most common species in human infection, was first isolated by Israel in 1891, and is the most prone to formation of the characteristic sulfur granules. These small yellow granules can often be grossly visible in the purulent material draini