Pulmonary actinomycosis from actinomyces meyeri presenting as a chest wall mass

Abstract

Actinomyces meyeri has been known to cause actinomycosis, although less commonly when compared to the other species in the Actinomyces genus. We report a patient who presented with a chest wall mass resembling sarcoma, later found to have pleuropulmonary actinomycosis that had fistulized into the subcutaneous tissues of the chest wall resulting in a mass. The organism isolated in cultures was A meyeri. The typical risk factors associated with this species including dental caries and significant alcohol use were evident in our patient. He received both medical therapy and adjunctive surgical drainage of the chest wall abscess resulting in complete resolution of the infection. Our case illustrates the importance of recognizing Actinomyces meyeri as a rare cause of actinomycosis. Additionally, one must be cognizant that invasive pulmonary actinomycosis is part of the differential diagnosis of an isolated chest wall mass. We also highlight the role of adjunctive surgical management for effective treatment of this infection. Copyright © 2013 by Lippincott Williams & Wilkins.