Multiple lung abscesses caused by Actinomyces graevenitzii mimicking acute pulmonary coccidioidomycosis

Abstract

Actinomyces graevenitzii is a newly recognized Actinomyces species that is seldom isolated from clinical specimens. A case of multiple pulmonary abscesses mimicking acute pulmonary coccidioidomycosis is described in this study, and the findings indicate that this organism is an opportunistic human pathogen.

Fig 1

Chest radiography film images 2 weeks before admission (clinical day 8), showing several nodules in the bilateral lower lung field (A), and on admission (clinical day 25), showing enlargement of the lung nodules, as the bilateral lower lung field is almost entirely covered by the lesions (B).

Fig 2

Chest CT image of the thorax 2 weeks before admission (clinical day 8), showing multiple round lesions located in both lobes with diameters of 1 to 2 cm (A), and on admission (clinical day 25), showing increases in the number and size (diameters of 2 to 4 cm) of the lung nodules (B).

Fig 3

Microphotographs and colony morphological features of the organism isolated from the bronchoalveolar lavage. Panel A shows numerous coryneform Gram-positive rods (Gram stain). Panel B shows the molar-tooth-like appearance of the colonies on blood agar (72 h after incubation).