Abstract
Herein, we report a 63-year-old patient with a background of COPD, heavy smoking, and poor dental hygiene presenting with progressive dyspnea, fever, and productive cough. The patient was worked up for possible pneumonia, but the chest radiograph revealed a right-sided pleural effusion. Further assessment of the pleural fluid revealed an exudative effusion. Histopathological examination of the pleural biopsy sample showed gram-positive branching filamentous rods with yellow Sulfur granules consistent with a diagnosis of pulmonary actinomycosis. The patient was initially treated with intravenous amoxicillin/sulbactam, then switched to oral amoxicillin. This case highlights a rare clinical presentation of pleural effusion in a patient with pulmonary actinomycosis.
Keywords: Pulmonary actinomycosis, Thoracic actinomycosis, COPD, Pleural effusion, sulfur granule