CTICasesPulmonary Actinomycosis
Imaging findings
A chest CT demonstrates a large, non-segmental right upper lobe consolidation with central low-attenuation fluid necrosis and cavitary changes, bounded inferiorly by the major fissure. Follow-up imaging one month after treatment shows a residual fibrocavitary mass that fails to collapse fully, indicating extensive localized parenchymal scarring.
Key takeaways
Actinomycosis is a slowly progressive, chronic bacterial infection that behaves like a "molding" process, often mimicking lung cancer or tuberculosis. The organism is frequently associated with poor oral hygiene and aspiration, forming large necrotic masses with dense surrounding fibrosis. Because of the intense chronic inflammatory response, the affected lung parenchyme often undergoes permanent fibrocavitary scarring and fails to fully re-expand after antibiotic treatment.
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