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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
 
BMJ Case Rep. 2010; 2010: bcr09.2009.2287.
Published online Mar 4, 2010. doi:  10.1136/bcr.09.2009.2287
PMCID: PMC3029460
Unusual association of diseases/symptoms
Haemoptysis in a patient of achalasia cardia: pulmonary actinomycosis, not tuberculosis
Abdul Majid Wani,1 Waleed Mohd Hussain,1 Abdulhakeem Amroon Banjar,1 Wail Hussain Al Miamini,1 Amer Mohd Khoujah,2 Mazen G Bafaraj,3 and Mubeena Akhtar1
1Hera General Hospital, Makkah, Western, 21955, Saudi Arabia
2National Guard Hospital, Jeddha, Western, 21955, Saudi Arabia
3Umul Qurah University, Makkah, 21955, Saudi Arabia
Correspondence to Abdul Majid Wani, dr_wani_majid/at/yahoo.co.in
Abstract
Actinomycosis is an infectious disease caused by anaerobic gram-positive, non-spore forming bacteria of the genus Actinomyces that affects the oropharynx, digestive tract, and genitalia. Thoracic actinomycosis may affect the respiratory tract and the pleura, even extending to the chest wall. Pulmonary actinomycosis occurs in immunocompetent persons during the fourth and fifth decades of life, with greater prevalence in men, and is generally due to Actinomyces israelii or A meyeri. It is frequently misdiagnosed as primary or metastatic lung cancer or conventional lung infections (eg, tuberculosis). The accepted predisposing factors for bronchopulmonary actinomycosis are poor dental hygiene, alcoholism and various chronic debilitating diseases, hiatus hernia, and gastro-oesophageal reflux. We report an interesting case of pulmonary actinomycosis presenting with haemoptysis, associated with achlasia cardia, and treated as tuberculosis.
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