Thoracic actinomycosis
Introduction
Introduction to chest actinomycosis Chest wall actinomycosis is a chronic suppurative granulomatous disease caused by actinomycetes infection. Long-term high-dose penicillin treatment has a certain effect. If the lesion is reduced by antibiotic treatment, the surgical resection should be thorough. The resection range includes chest wall lesions and lung tissue of the original cupping net. If necessary, local muscle flaps are filled. basic knowledge The proportion of illness: 0.002% Susceptible people: good for men Mode of infection: non-infectious Complications: pneumonia
Cause
Cause of chest actinomycosis
Cause:
Inhalation of actinomycetes from the respiratory tract causes lung actinomycosis. Actinomycetes are often parasitic in human oral cavity. They are conditional pathogens. When the body's resistance is reduced, the disease can be induced. The chest wall actinomycosis is caused by the line. Chronic pyogenic granulomatous diseases caused by bacterial infection, such as the spread of the chest wall actinomycosis.
Prevention
Prevention of chest actinomy
1. Adjust daily life and workload, and regularly carry out activities and exercise to avoid fatigue.
2. Maintain emotional stability and avoid emotional excitement and tension.
3. Keep the stool smooth, avoid using stools, eat more fruits and high-fiber foods.
Complication
Chronic actinomy complications Complications pneumonia
Abscess, infection.
Symptom
Symptoms of actinomy on the chest Common symptoms Malignant abscess sinus skin appears scleromorphosis
Thoracic actinomycosis is common in men aged 30-60 years. A unique plate-like lumps can be seen on the chest wall, which is dark purple. A small abscess formed by local softening can be seen, such as a small sinus ostium after rupture, but clinically positive. Low rate, chronic long-term patients can lead to cachexia and visceral amyloidosis, but also can be invaded by the chest wall and the mediastinum of the mediastinum, esophagus, spine, heart muscle, etc., poor prognosis.
Examine
Examination of chest actinomycosis
Pathogen inspection:
1. Direct microscopic examination: Gram staining of granules can be seen, blue mycelial masses and rods can be seen, and pus smears may also find small and short branch-like hyphae, which are negative for acid-resistant staining, and note that acid-fast staining of Nocardia Positive, Streptomyces spores, can be identified.
2, bacterial culture: more difficult, the particles must be washed with sterile saline several times to remove bacteria, then crushed with a sterile glass rod, streaked on brain heart infusion blood agar, into the CO2 anaerobic bacteria tank, Cultivate at 37 °C.
Histopathology: early local leukocyte infiltration, formation of small abscess, piercing to form sinus, each sinus can communicate, the body fascia, pleura, diaphragm, bones, etc. can not prevent its development, there may be chronic granulation tissue near the suppuration area Hyperplasia, may be lymphatic cells, plasma cells, tissue cells and fibroblasts infiltration, local tissue can also be glass-like degeneration, hard plate-like hardening, "sulphur particles" can be seen inside the abscess, 100 ~ 300m diameter, HE The center of the staining is homogenous and there are palisade-like short rod-like cells around it.
Diagnosis
Diagnosis and identification of chest actinomycosis
Typical clinical manifestations, special imaging findings, sulfur particles found in the pus, diagnosis is not difficult. It should be noted that the surface of the neck, chest and abdominal wall is stiff and should be suspected. All the fistula sinus discharge pus to find "sulphur particles" should be in-depth examination. Some unexplained fistulas and sinus should be further investigated. In addition, it can be further diagnosed by combining pathogenic examination and histopathology.
The disease should be differentiated from tuberculosis, tumor, liver abscess, lumbar abscess, osteomyelitis, appendicitis, fungal foot disease, grape plague, nocardiosis, ulcerative skin tuberculosis: more common in children, occurs in Cervical side, armpit, chest and groin, early skin lesions are soy-sized subcutaneous nodules, movable, hard, painless, adhesion to the skin, followed by cheese-like necrosis, ulceration, formation of fistula, and more There are atrophic short marks, and histopathological examination is tuberculous granulomatous changes.
