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Acta Médica Peruana

On-line version ISSN 1728-5917


NAKANDAKARI, Mayron D; DE LA ROSA, Dyanne N; GUTIERREZ, Jorge L  and  BRYSON, Walter. A patient with primary pulmonary botryomycosis mistaken with actinomycosis: a lethal and uncommon infectious disease. Acta méd. Peru [online]. 2018, vol.35, n.4, pp.233-238. ISSN 1728-5917.

Botryomycosis is a lethal and uncommon granulomatous and suppurative bacterial infection. We present the case of a 52-year old female patient who was readmitted because of a respiratory disease that became complicated. She had had cough, dyspnea, fever, loss of appetite, and weight loss. A pulmonary CT scan showed fibrosis, bilateral alveolar infiltrate, cavities, and bilateral bronchiectasis. Bronchial aspirate cytology showed azurophilic granules, leading to suspect a diagnoses of actinomycosis, so penicillin was started, but no improvement was observed. In the second culture of bronchial aspirate two groups of Gram-negative bacteria colonies resembling Escherichia coli were observed, but also images resembling azurophilic granules were found, so the definitive diagnosis proposed was pulmonary botryomycosis caused by BLEE E. coli; nonetheless, the patient had just passed away. As a conclusion, an infectious disease with a very low prevalence is reported, where an early diagnosis is extremely important in order to reduce its high lethality rate.

Keywords : Escherichia coli; Acinetobacter baumannii; Actinomycosis.

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