Pulmonary Actinomycosis Complicated by Pneumothorax Treatment

Pulmonary actinomycosis in human beings is still a comparative rarety in the United States. On the European Continent, and particularly in Germany, Austria, and Russia, lung infection with actinomycosis is seen fairly often. The old theory that actinomycosis is contracted by chewing straws and grasses is at present held not to be well founded; at least from the clinical standpoint, this hypothesis in cases reported in the literature has not been substantiated. Aspiration as a means of infection was definitely proved in a number of cases by finding aspirated foreign bodies such as pieces of carious teeth surrounded by the organism. The infection apparently takes place by direct aspiration of infective material through the air passages and occasionally by way of metastasis through the blood stream. The cavity of a carious tooth appears to be a frequent seat of actinomycotic infection. It is uncertain whether or not the actinomyces are able to pass through an intact mucous membrane. However, a number of cases are on record in which infection followed wounds or injuries. During the World War, for instance, we saw a number of cases, where soldiers who had sustained abdominal and pelvic injuries were later found to have actinomycosis, probably as a result of having been bedded on grain stalks and straw. The actinomyces, in these cases, undoubtedly entered by the open wounds.