Actinomycose pulmonaire fistulisée à la paroi thoracique chez un enfant

RésuméL’actinomycose est une affection suppurative due à des bactéries du genre Actinomyces. La localisation pulmonaire est rare chez l’enfant et de diagnostic difficile, pouvant simuler une tuberculose ou un processus néoplasique. En l’absence de traitement, les lésions pulmonaires peuvent évoluer vers l’extension, le ramollissement et la fistulisation vers les parties molles. Nous rapportons un cas d’actinomycose pulmonaire post-traumatique fistulisée à la paroi chez un enfant de 13 ans, ayant eu une évolution favorable sous-traitement.

SummaryIntroductionActinomycosis is a suppurative infection caused by bacteria of the Actinomyces genus. It is a rare cause of pulmonary infection and can be difficult to diagnose because its presentation may mimic tuberculosis or cancer. In the absence of treatment of pulmonary lesions fistulae can develop. We report a case of thoracic actinomycosis with chest wall involvement in a child, managed in the pediatric department at Moulay Youssef University Hospital in Rabat, Morocco.Case reportWe report the case of a 13-year-old boy with a history of trauma to the right chest 1 year earlier, admitted with right-sided chest wall swelling with cutaneous fistulae. Physical examination identified a parietal mass with fistulization to the skin. Laboratory tests showed an inflammatory syndrome. The chest x-ray revealed moderate right pleural effusion. The thoracic computed tomography scan showed a right parietal pleural mass and the percutaneous biopsy confirmed the diagnosis of actinomycosis. The patient underwent antibiotic therapy with favorable evolution.ConclusionThe diagnosis, the clinical, radiological and histological pattern, and the therapeutic features are described in this report.