Pulmonary Actinomycosis Imitating Malignancy in an Epileptic Patient

The diagnosis of pulmonary actinomycosis is still a difficult problem in medical practice. A 38 year old female who had been using antiepileptic drugs for 27 years was admitted to our hospital with complaints of cough and yellowish sputum of six months duration. Physical examination of the patient was unremarkable. Chest radiography showed a lesion involving the pleura of the right hemithorax. Thorax CT revealed a hypodense mass. Fiberoptic bronchoscopic examination and transbronchial biopsy were not diagnostic. The patient was diagnosed as pulmonary actinomycosis after diagnostic thoracotomy. In the present report, we concluded that pulmonary actinomycosis must be kept in mind in the differential diagnosis of an epileptic patient with the radiological findings of malignancy.