Abstract:

Background- Actinomycosis is an uncommon disease caused by Actinomyces spp., Gram-positive, anaerobic or microaerobic bacteria that normally colonize the human mouth and GIT and genital tracts. Cardio-pulmonary actinomycosis with peritoneal involvement is a rare presentation.

Case report – A 29 years old female normotensive and euglycemic, smoker with poor oral hygiene was referred to us an outside hospital with complaints of right lower chest pain with severe shortness of breath and low grade fever last 4 hrs . On examination she showed dental caries, right chest bulging with diminished breath sounds, distended abdomen, raised WBC counts and normal ECG, Chest X-Ray showed right sided pleural effusion and bilateral opacities, pericardial effusion and ascites which were confirmed by 2D echo, CT chest & abdomen . Lab tests were negative for tuberculosis or malignancy. Finally she was diagnosed as an actinomycosis israelii based on culture and biopsy. She was treated with long course of appropriate antibiotics and fluid drainage.

Conclusion-Patients with actinomycosis require prolonged high doses of penicillin G or amoxicillin and other sensitive antibiotics and drainage. Early diagnosis will reduce the hospital stay or mortality in such kind of patients.

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