Page 60 - ECBIP 2021_Program

6th European Congress ECBIP 15 - 17
Book of Abstracts
for Bronchology and
Interventional Pulmonology ATHENS - GREECE 2021
OCTOBER
MODERATED e-POSTER SESSION 04:
Central airways obstruction and foreign body extraction
ENDOBRONCHIAL ACTINOMYCOSIS: LOOK FOR FOREIGN BODY ASPIRATION
Evangelia Koukaki1, Nektarios Anagnostopoulos1, Philippos Emmanouil2, Vlasios Vitsas2, Konstantinos Porpodis1, Grigorios Stratakos1
1 1st Respiratory Department, National & Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
2 Interventional Pulmonology Department, Mediterraneo Hospital, Athens, Greece
PP29
Introduction: Pulmonary actinomycosis is a rare and difficult to diagnose disease. Actinomyces Israeli is part of the oral flora and can cause abscesses or necrotic tumors after aspiration, mimicking neoplasia. Furthermore, endobronchial actinomycosis is an even more rare disease presenting with endobronchial tumours which obstruct central airways and cause post-obstructive atelectasis. It is commonly associated with foreign body aspiration for a long period of time.
Methods: We present 2 patients with chronic cough and recurrent respiratory infections,in whom central airway obstruction was found and attributed to endobronchial actinomycosis.
Results:
Case 1: Female, 25 years old, with a history of right lower lobe resection (3 years ago) due to pulmonary abcess, presented with chronic cough, recurrent episodes of hemoptysis and long-lasting low-grade fever. In her chest CT middle lobe atelectasis and post-obstructive pneumonia was detected. During fiberoptic bronchoscopy biopsy taken from an exophytic lesion blocking middle lobe bronchus revealed actinomycosis. With the use of electrocautery and APC the lesion was cleared, revealing the presence of a foreign body (surgical stiches from the lobectomy) which was removed. Large quantities of pus were also evacuated. The patient received a course of antibiotics and since then remains asymptomatic.
Case 2: Female, 45 years old, with a history of possible foreign body aspiration at the age of 15 (part of a plastic flower), presented with recurrent respiratory infections for the last 8 years. In previous multiple bronchoscopies, submucosal / mucosal infiltration and serious stenosis of lingula was detected. With rigid bronchoscopy and the use of electrocautery, complete opening of the bronchus revealed the 30-year-old foreign body which was removed. The biopsy of the surrounding tissue was compatible with actinomycosis.The patient since then remains asymptomatic.
Conclusion: Endobronchial actinomycosis is linked to chronic foreign body aspiration and is an easy to miss diagnosis, mimicking cancer or tuberculosis. Interventional pulmonology can effectively identify and manage both foreign bodies and endobronchial actinomycosis, avoiding the need for a major surgery.
60 6th European Congress for Bronchology and Interventional Pulmonology