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Case Reports
. 2016 Aug 1;114(4):e233-6.
doi: 10.5546/aap.2016.e233. Epub 2016 Aug 1.

[Pulmonary actinomycosis and tuberculosis. A comorbidity pediatric case]

[Article in Spanish]
Elsa D Bisero  1 , Graciela F Luque  2 , Cristina N Rizzo  2 , Alejandra E Zapata  3 , María S Cuello  4
Affiliations
Free article
Case Reports

[Pulmonary actinomycosis and tuberculosis. A comorbidity pediatric case]

[Article in Spanish]
Elsa D Bisero et al. Arch Argent Pediatr. .
Free article

Abstract
in English, Spanish

Actinomycosis is a chronic suppurative infection, produced by anaerobic Gram-positive bacteria or microaerobic Actinomyces species. It is rare in children and adolescents and it is more common in immunocompromised. Mycobacterium tuberculosis collaborates on the development of the disease. Pulmonary involvement appears as a picture of chronic condensation that does not improve with conventional antibiotic treatment. Classic complications affecting the thoracic wall with drainage in «sulfur granule» and fistulization are described less frequently nowadays. The diagnosis is a real challenge and it is set by using the isolation of species of Actinomyces. The treatment of choice for all clinical forms of the disease is the prolonged use of antibiotics.

Objective: to present a pediatric case of comorbidity between tuberculosis and actinomycosis and to highlight the importance of diagnostic suspicion of actinomycosis in the presence of all chronic suppurative processes.

La actinomicosis es una infección supurativa crónica, producida por bacterias Gram-positivas anaeróbicas o especies Actinomyces microaerófilas. Es rara en niños y adolescentes; es más común en inmunodeprimidos. El Mycobacterium tuberculosis colabora en el desarrollo de la enfermedad. La afectación pulmonar aparece como un cuadro de condensación crónica que no mejora con el tratamiento antibiótico convencional. Las complicaciones clásicas de afectación de la pared torácica con fistulización y supuración en «granulo de azufre» son descritas con menor frecuencia en la actualidad. El diagnóstico es un verdadero desafío y se establece mediante el aislamiento de las especies de Actinomyces. El tratamiento de elección para todas las formas clínicas de la enfermedad es el uso prolongado de antibióticos. Objetivo. Presentar un caso pediátrico de comorbilidad entre tuberculosis y actinomicosis. Resaltar la importancia de la sospecha diagnóstica de actinomicosis frente a todo proceso supurado crónico.

Keywords: Actinomyces spp.; Granuloma; Mycobacterium tuberculosis; Sulfur granules; Thoracic actinomycosis.

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