CTICasesPulmonary Actinomycosis with Empyema
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Imaging findings
Initial chest radiographs and CT demonstrate right lower lobe consolidation with central low-attenuation necrosis, accompanied by a small pleural effusion. A subsequent chest radiograph and chest CT obtained one month later show the interval development of a large, complex, loculated right pleural fluid collection (empyema) and the resolution of the parenchymal consolidation.
Key takeaways
Pulmonary actinomycosis is a chronic, slowly progressive, granulomatous infection caused by Actinomyces species. While typically presenting as a smoldering mass that can cross anatomical boundaries into the pleura and chest wall, it can sometimes progress rapidly to a frank empyema. The standard treatment is long-term high-dose intravenous penicillin G.
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