Key Words: empyema, hemoptysis, actinomycosis, pediatrics, Peru
Abstract
Introduction
Actinomycosis is a rare infectious disease caused by Gram-positive bacteria. The most common species is Actinomyces israelii. Among its forms of presentation, the thoracic is the least frequent.
Case presentation
We report two patients with thoracic actinomycosis, 8 and 13 years old, from different geographical areas of Peru. The first case had empyema necessitans and the second, lung consolidation and recurrent hemoptysis. Both had a certain degree of difficulty in their diagnosis but responded favorably to antibiotics and surgical treatment. The diagnosis was based on the histopathological study. However, we were not able to ascertain the species of actinomyces.
Conclusion
Thoracic actinomycosis is rare in children and presents as a parenchymal lesion with possible fistulization to the chest wall. This article is one of the few in the Peruvian literature, constituting a contribution to the knowledge of the disease and its management in pediatrics.
No English version is available for this article.
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Introducción
La actinomicosis es una enfermedad infecciosa poco frecuente, ocasionada por una bacteria Gram positiva. La especie más común es Actinomyces israelii. Dentro de sus formas de presentación, la torácica es la menos frecuente.
Presentación de casos
Reportamos dos pacientes con actinomicosis torácica de 8 y 13 años de diferentes zonas geográficas de Perú. El primer caso tuvo empiema necessitatis y el segundo, consolidación pulmonar y hemoptisis recurrente. Ambos tuvieron cierto grado de dificultad en su diagnóstico, pero con una buena respuesta al tratamiento antibiótico y quirúrgico. El diagnóstico fue mediante estudio histopatológico. Sin embargo, no se pudo identificar la especie de Actinomyces.
Conclusión
La actinomicosis torácica es poco frecuente en niños y se presenta como una lesión parenquimal con posible fistulización a la pared torácica. Este es uno de los pocos casos reportados en la literatura peruana, constituyendo una contribución al conocimiento de esta enfermedad y su manejo en pediatría.
Authors:
Héctor Nuñez-Paucar[1], Carlos Valera-Moreno[1], Mariela Katherine Zamudio-Aquise[1], Fabio Pérez-Garfias[1], Eduardo Jesús Guzmán-Quispe[1], Carlo Calizaya-Gallegos[2], Maycol Suker Ccorahua-Rios[3], Ana Claudia Santander-Cahuantico[3], Marco Edmundo Ordoñez-Linares[3], Noé Atamari-Anahui[1,4]
Affiliation:
[1] Instituto Nacional de Salud del Niño-Breña, Lima, Perú
[2] Servicio de Pediatría, Hospital San José del Callao, Lima, Perú
[3] Asociación Científica de Estudiantes de Medicina Humana del Cusco (ASOCIEMH CUSCO), Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Perú
[4] Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Perú
E-mail: noe.atamari@gmail.com
Author address:
[1] Avenida La Fontana 550, La Molina Lima, Perú
Citation: Nuñez-Paucar H, Valera-Moreno C, Zamudio-Aquise MK, Pérez-Garfias F, Guzmán-Quispe EJ, Calizaya-Gallegos C, et al. Pulmonary actinomycosis in children: report of two Peruvian cases. Medwave 2020;20(7):e7986 doi: 10.5867/medwave.2020.07.7986
Submission date: 17/4/2020
Acceptance date: 30/6/2020
Publication date: 6/8/2020
Origin: Not commissioned
Type of review: Externally peer-reviewed by three reviewers, double-blind
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Kabiri M, Zidane A, Arsalane A, Kabiri EH. L'actinomycose pulmonaire chez l'enfant [Pulmonary actinomycosis in a child]. Arch Pediatr. 2008 Aug;15(8):1312-4. | CrossRef | PubMed |Bartlett AH, Rivera AL, Krishnamurthy R, Baker CJ. Thoracic actinomycosis in children: case report and review of the literature. Pediatr Infect Dis J. 2008 Feb;27(2):165-9. | CrossRef | PubMed |Munive L, Ramos W, Mendivil R, Paira E, Mendiola G, Chávez G. Actinomicosis de pared abdominal: reporte de dos casos en un hospital general de la ciudad de Lima. Rev Peru Epidemiol. 2009;13(2):1-5. [On line]. | Link |El Koraichi A, Oulahyane R, Abbassi A, Benjelloun MY, Kisra M, Benhmamouch N. Childhood thoracic actinomycosis: case report. J Pediatr Surg. 2012 Jun;47(6):e15-7. | CrossRef | PubMed |Ronceray L, Friesenbichler W, Hutter C, Lakatos K, Krizmanich W, Amann G, et al. Thoracic Actinomycosis With Infiltration of the Spine: An Oncological Pitfall. J Pediatr Hematol Oncol. 2018 Aug;40(6):468-471. | CrossRef | PubMed |Brizuela ME, Latella A, Sancho Cano J, Litterio M, Berberian G. Actinomicosis torácica: presentación de un caso [Thoracic actinomycosis: report of a case]. Arch Argent Pediatr. 2015 Dec 1;113(6):e345-8. | CrossRef | PubMed |Sandoval-Mallma E, Caballero-Silva J. Actinomicosis diseminada en un paciente inmunocompetente: Reporte de caso. Horiz Méd Lima. 2019;19(3):89-95. | CrossRef |Valverde J, Tincopa L, Albújar P, Rojas E, Zapata C, Rojas P. Actinomicosis toracica en un paciente epiléptico. Dermatol Peru. 2002;12(1):61-3. [On line]. | Link |Medina Flores J, Paz Carrillo E, Morales Paitan C. Actinomicosis torácica en niños. Reporte de dos casos. Diagnostico. 1999;38(3):1-5. [On line]. | Link |Mabeza GF, Macfarlane J. Pulmonary actinomycosis. Eur Respir J. 2003 Mar;21(3):545-51. | CrossRef | PubMed |Pereira N, Cuevas P, Valencia C, Vega J, Gallegos I, Fernández JG, et al. Actinomicosis torácica como diagnóstico diferencial de neoplasia: a propósito de un caso [Thoracic actinomycosis in the differential diagnosis of neoplasm: a propos of a case]. Rev Chilena Infectol. 2012 Aug;29(4):455-8. | CrossRef | PubMed |Bisero ED, Luque GF, Rizzo CN, Zapata AE, Cuello MS. Tuberculosis y actinomicosis. Un caso pediatrico de comorbilidad [Pulmonary actinomycosis and tuberculosis. A comorbidity pediatric case]. Arch Argent Pediatr. 2016 Aug 1;114(4):e233-6. | CrossRef | PubMed |Yeung VH, Wong QH, Chao NS, Leung MW, Kwok WK. Thoracic actinomycosis in an adolescent mimicking chest wall tumor or pulmonary tuberculosis. Pediatr Surg Int. 2008 Jun;24(6):751-4. | CrossRef | PubMed |Cheon JE, Im JG, Kim MY, Lee JS, Choi GM, Yeon KM. Thoracic actinomycosis: CT findings. Radiology. 1998 Oct;209(1):229-33. | CrossRef | PubMed |Heo SH, Shin SS, Kim JW, Lim HS, Seon HJ, Jung SI, et al. Imaging of actinomycosis in various organs: a comprehensive review. Radiographics. 2014 Jan-Feb;34(1):19-33. | CrossRef | PubMed |Gómez Mateo Mdel C, Urbano Salcedo A, Toro de Méndez M, Ferrández Izquierdo A. Actinomicosis pulmonar. Diagnóstico por punción-aspiración con aguja fina [Pulmonary actinomycosis. Fine needle aspiration diagnostic]. Invest Clin. 2011 Dec;52(4):358-64. | PubMed |Custal-Teixidor M, Trull-Gimbernat JM, Garijo-López G, Valldosera-Rosello M. Fine-needle aspiration cytology in the diagnosis of cervicofacial actinomycosis: report of 15 cases. Med Oral Patol Oral Cir Bucal. 2004 Nov-Dec;9(5):467-70; 464-7. | PubMed |Smith AJ, Hall V, Thakker B, Gemmell CG. Antimicrobial susceptibility testing of Actinomyces species with 12 antimicrobial agents. J Antimicrob Chemother. 2005 Aug;56(2):407-9. | CrossRef | PubMed |Choi J, Koh WJ, Kim TS, Lee KS, Han J, Kim H, et al. Optimal duration of IV and oral antibiotics in the treatment of thoracic actinomycosis. Chest. 2005 Oct;128(4):2211-7. | CrossRef | PubMed |
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