Aktinomikoza pluća – dijagnostička dilema

  • Vladan Živković Military Medical Academy, *Clinic for Pulmonology, Belgrade, Serbia
  • Sanja Šarac Military Medical Academy, *Clinic for Pulmonology, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Svetlana Popović Military Medical Academy, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  • Miloš Zarić Military Medical Academy, Institute of Pathology and Forensic Medicine, Belgrade, Serbia
  • Saša Ristić Military Medical Academy, Institute of Pathology and Forensic Medicine, Institute of Radiology, Belgrade, Serbia
  • Vanja Kostovski Military Medical Academy, Clinic for Thoracic Surgery, Belgrade, Serbia
  • Jasna Pešić Military Medical Academy, Institute of Radiology, Belgrade, Serbia
  • Bojan Nikolić Military Medical Academy, Institute of Radiology, Belgrade, Serbia
  • Bojan Rakonjac Military Medical Academy, Institute of Microbiology, Belgrade, Serbia
  • Jelena Vuković Military Medical Academy, *Clinic for Pulmonology, Belgrade, Serbia; †University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP251104016Z
Ključne reči: actinomyces;, aktinomikoza;, biopsija;, bronhoskopija;, dijagnoza;, tomografija, kompjuterizovana, multidetektorska;, torakoskopija.

Sažetak


Uvod. Aktinomikoza pluća je hronična zapaljenska infektivna bolest koju izaziva anaerobna i/ili mikroaerofilna bakterija iz roda Actinomyces spp. Izaziva nespecifične simptome kod bolesnika i daje atipičnu kliničku i radiografsku sliku. Veoma je retka i karakteriše je stvaranje apscesa i fistula u plućima, ili lokalna fibroza. U diferencijalnoj dijagnozi moraju se razmotriti bolesti i patološka stanja od tuberkuloze pluća do neoplastičnog procesa u plućima. Prikaz bolesnika. Predstavljamo 39-godišnjeg bolesnika sa infiltrativnom promenom u gornjem delu desnog plućnog krila i nespecifičnim simptomima. Kod ovog bolesnika, aktinomikoza je patohistološki dokazana posle hirurške intervencije. U periodu od nešto više od mesec dana, dva puta su urađene multidetektorska kompjuterizovana tomografija grudnog koša i bronhoskopija sa transbronhijalnom biopsijom i bronhijalnim brisom. U početku se nije sumnjalo na aktinomikozu pluća. Nakon atipične resekcije tumorske mase u gornjem delu desnog plućnog krila i histopatološki dokazane infekcije, bolesnik je lečen antibiotskom terapijom u trajanju od 6 meseci. Sprovedena su dalja ispitivanja da bi se potvrdila moguća primarna ili sekundarna imunodeficijencija. Zaključak. Kod bolesnika sa nespecifičnim promenama u plućnom parenhimu treba sumnjati i na aktinomikozu, a nakon dijagnoze potrebno je dopuniti ispitivanje kako bi se potvrdila ili isključila imunodeficijencija.

Biografija autora

Sanja Šarac, Military Medical Academy, *Clinic for Pulmonology, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia

Klinika za pulmologiju

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Objavljeno
2026/04/27
Broj časopisa
Vol. 83 Br. 04 (2026): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika