56 Pulmonary Actinomyces

Clinical Presentation

39-year-old man presents with fever, cough, sputum production, and left-sided chest pain

Radiologic Findings

PA chest radiograph (Fig. 56.1A) shows an ill-defined left upper lobe perihilar mass-like opacity without air bronchograms. Contrast-enhanced chest CT (mediastinal window) (Fig. 56.1B) reveals a mass-like region of consolidation in the medial anterior segment of the left upper lobe that invades the adjacent anterior mediastinum and left anterior chest wall. Note the heterogeneous attenuation infiltrative process producing asymmetric thickening of the left pectoralis muscles.