Pulmonary Actinomycosis Causing an Unusual Presentation in a Patient with COPD: A Case Report

TL;DR

A 63-year-old COPD patient with poor dental hygiene was diagnosed with pulmonary actinomycosis after presenting with unusual symptoms like pleural effusion.

Contribution

This case report presents a rare presentation of pulmonary actinomycosis causing pleural effusion in a COPD patient.

Findings

Histopathological analysis confirmed pulmonary actinomycosis with yellow sulfur granules.

Treatment with amoxicillin/sulbactam followed by oral amoxicillin was effective.

The case highlights the importance of considering actinomycosis in patients with atypical respiratory symptoms.

Abstract

We present the case of a 63-year-old male patient with a history of chronic obstructive pulmonary disease (COPD), heavy smoking, and poor dental hygiene, who presented with progressive dyspnea, fever, and a productive cough. The patient was initially evaluated for pneumonia, but a chest radiograph revealed a right-sided pleural effusion. Further analysis of the pleural fluid showed an exudative effusion. Histopathological examination of a pleural biopsy sample identified gram-positive branching filamentous rods with yellow sulfur granules, consistent with a diagnosis of pulmonary actinomycosis. The patient was initially treated with intravenous amoxicillin/sulbactam, later switched to oral amoxicillin. This case highlights a rare clinical presentation of pleural effusion in a patient with pulmonary actinomycosis.

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