Open AccessBronchoscopic View of a Tuberculosis Cavity With Actinomyces
Author(s) -
Ali Saeed,
Muhammad Ali Raza,
Franklin R. McGuire,
James A. Barker
Publication year - 2009
Publication title -
journal of bronchology and interventional pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.648
H-Index - 33
eISSN - 1944-6586
pISSN - 1948-8270
DOI - 10.1097/lbr.0b013e31819b2263
Subject(s) - actinomyces , bronchoalveolar lavage , medicine , actinomycosis , sputum , tuberculosis , biopsy , bronchoscopy , pathology , cytology , flexible bronchoscopy , gold standard (test) , radiology , lung , bacteria , genetics , biology
Coexistence of pulmonary actinomycosis with tuberculosis has rarely been reported. The presence of Actinomyces in sputum and bronchoalveolar lavage is inadequate for diagnosis, as it may represent mere colonization. Traditionally, excisional biopsy is considered to be the gold standard for histologic diagnosis. There are multiple case reports in which the diagnosis of pulmonary actinomycosis was based on bronchial biopsy and Wang needle aspiration. We describe an incidental finding of a bronchial communication with passage of a flexible bronchoscope into the tuberculosis cavity. The images reveal a 5-cm cavity with a whitish, stone-like structure noticed to move back and forth with respiration. Colonies of Actinomyces were seen on transbronchial brushing cytology. Bronchoalveolar lavage cultures were negative. To our knowledge such a detailed pictorial description of a tuberculosis cavity with Actinomyces has not been reported in the past.