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Surgery in thoracic actinomycosis.

机译:胸部放线菌病的手术。

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Background: diagnosis and treatment of thoracic actinomycosis is difficult. In most cases, surgery is performed to rule out lung cancer or to control severe symptoms such as hemoptysis. Methods: 6 patients with a mean age of 42 years underwent pulmonary resection and were given a pathologic diagnosis of thoracic actinomycosis at our institution between 2003 and 2010. We reviewed preoperative clinical characteristics, computed tomography findings, surgical indication, postoperative clinical course and outcome. Results: All patients were symptomatic. One patient had a history of cervical actinomycosis. The mean interval between radiographic identification of the abnormality and surgical intervention was 8 months (range, 4-17 months). Radiographic findings in all cases included a mass-like appearance, simulating lung malignancy or chronic suppuration. The various histological and bacteriological examinations had failed to make the diagnosis. Thoracic actinomycosis was confirmed after thoracic surgery. All patients received penicillin-based antibiotic treatment for at least 2 to 3 months. Good clinical results were observed in 5 patients. In one patient, we noted recurrence of actinomycosis after 10 months; it was a multidrug-resistant form. Conclusion: diagnosis of actinomycosis can be problematic because of difficulty in isolating actinomyces. In these cases, surgery is very helpful.
机译:背景:胸放线菌病的诊断和治疗很困难。在大多数情况下,进行手术以排除肺癌或控制严重症状,例如咯血。方法:2003年至2010年间,对6例平均年龄为42岁的患者进行了肺切除术,并对我院进行了胸段放线菌病的病理学诊断。结果:所有患者均出现症状。一名患者有宫颈放线菌病病史。影像学发现异常与手术干预之间的平均间隔为8个月(范围4-17个月)。所有病例的影像学表现均包括肿块样外观,模拟肺部恶性肿瘤或慢性化脓。各种组织学和细菌学检查均未能作出诊断。胸外科手术后证实胸椎放线菌病。所有患者均接受了以青霉素为基础的抗生素治疗至少2至3个月。在5名患者中观察到良好的临床结果。在一名患者中,我们注意到放线菌病在10个月后复发。这是一种耐多药的形式。结论:放线菌病的诊断存在困难,因为难以分离放线菌。在这些情况下,手术非常有帮助。

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