A Life-Threatening Cause of Stridor, Primary Tracheal Actinomycosis

TL;DR

A 47-year-old woman had a rare case of tracheal actinomycosis, a bacterial infection, causing breathing issues and throat pain, diagnosed and treated with tracheal dilatation.

Contribution

This case report highlights a rare presentation of tracheal actinomycosis managed with tracheal dilatation for diagnosis and treatment.

Findings

CT imaging showed tracheal thickening and airway narrowing.

Biopsy confirmed Actinomyces infection with PAS-positive filamentous bacilli.

Tracheal dilatation aided both diagnosis and therapeutic management of tracheal stenosis.

Abstract

Actinomycosis is a chronic, suppurative infection caused by Actinomyces israelii, an anaerobic bacterium that is part of the normal oral flora. A 47-year-old woman presented to the clinic with dyspnea and sore throat. Computed tomography(CT) revealed thickening of the proximal tracheal lumen and airway narrowing. Pathological examination of biopsy specimens obtained by rigid bronchoscopy revealed periodic acid-Schiff (PAS)(+) bacterial colonization with filamentous bacilli, consistent with Actinomyces. This report describes an uncommon presentation of tracheal actinomycosis in which tracheal dilatation was performed for both diagnostic sampling and therapeutic management of tracheal stenosis.

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