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