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Endobronchial Actinomycosis Associated With an Inorganic Foreign Body
Actinomicosis sobre cuerpo extraño inorgánico endobronquial
Cristina Benito Bernáldez
, Estefanía Luque Crespo, Virginia Almadana Pacheco
Corresponding author
Servicio de Neumología, Hospital Universitario Virgen Macarena, Sevilla, Spain
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Bronchoscopic images showing foreign body occupying left principal bronchus, surrounded by significant granulomatous reaction (C), and image after extraction of the foreign body, with a completely clear bronchial lumen (D).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 79-year-old man with a history of laryngeal cancer who underwent total laryngectomy in 2010 with tracheotomy and subsequent placement of a voice prosthesis in 2012. He attended the emergency room for chest pain and dyspnea. CT-angiogram of the chest revealed incomplete obliteration of the left principal bronchus (LPB), and an image of a metallic foreign body in the interior of the airway was identified, along with distal alveolar infiltrate in the left lung base (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Fiberoptic bronchoscopy showed a foreign body (voice prosthesis) occupying the LPB surrounded by a significant granulomatous reaction, which could be extracted with biopsy forceps (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Histopathological examination of the bronchial biopsy revealed a nonspecific inflammatory process with presence of foreign material and abundant colonies of actinomyces.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Endobronchial actinomycosis is very rare and has occasionally been described in association with the aspiration of a foreign body.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> In our case, the foreign body was inorganic − only 3 cases of this association have been reported in the literature.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> The patient reported that he had aspired the voice prosthesis over 24 months previously, without symptoms. The patient did not require antibiotic treatment after the foreign body had been completely extracted by bronchoscopy.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Benito Bernáldez C, Luque Crespo E, Almadana Pacheco V. Actinomicosis sobre cuerpo extraño inorgánico endobronquial. Arch Bronconeumol. 2017;53:689.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1244 "Ancho" => 1658 "Tamanyo" => 233510 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest CT-angiogram showing foreign body in left principal bronchus (A) and distal alveolar infiltrate in the left lung base (B). Bronchoscopic images showing foreign body occupying left principal bronchus, surrounded by significant granulomatous reaction (C), and image after extraction of the foreign body, with a completely clear bronchial lumen (D).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endobronchial actinomycosis associated with a foreign body – successful short-term treatment with antibiotics" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Maki" 1 => "N. Shinagawa" 2 => "Y. Nasuhara" 3 => "S. Oizumi" 4 => "H. Domen" 5 => "H. Haga" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Inter Med" "fecha" => "2010" "volumen" => "49" "paginaInicial" => "1293" "paginaFinal" => "1296" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endobronchial actinomycosis associated with nonorganic foreign body aspiration after years of latency" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Singh" 1 => "S. Singh" 2 => "J. Jyotimallika" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bronchol Intervent Pulmonol" "fecha" => "2015" "volumen" => "22" "paginaInicial" => "180" "paginaFinal" => "182" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000012/v1_201711290721/S1579212917303488/v1_201711290721/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000012/v1_201711290721/S1579212917303488/v1_201711290721/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917303488?idApp=UINPBA00003Z" ]
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