Pulmonary actinomycosis and pulmonary nocardiosis mimicking lung cancer: A case series and narrative review
Abstract
Pulmonary actinomycosis and pulmonary nocardiosis are rare chronic respiratory infections that may closely resemble lung cancer due to their overlapping clinical, radiological, and bronchoscopic characteristics. This hybrid case series and narrative review aims to elucidate the presenting patterns, diagnostic pathways, management strategies, and practical implications of these infections in the differential diagnosis of lung cancer. We analyzed four consecutive cases managed at the Sotiria Thoracic Diseases General Hospital in Athens from 2021 to 2025, supplemented by eight additional cases identified through a review of Greek grey literature from the same period. In the 12 cases reviewed, patients commonly presented with cough, dyspnea, fever, hemoptysis, malaise, and weight loss. Chest imaging frequently revealed consolidation, cavitation, atelectasis, nodules, or mediastinal lymphadenopathy, often prompting an oncological evaluation. Bronchoscopic findings occasionally mimicked malignant submucosal spread, and increased fluorodeoxyglucose uptake added to the diagnostic uncertainty. Notably, one case exhibited coexistence of pulmonary actinomycosis with lung adenocarcinoma. Microbiological and histopathological evaluations confirmed the diagnoses, and most patients showed clinical and radiological improvement following prolonged targeted antimicrobial therapy. Given these findings, pulmonary actinomycosis and nocardiosis should be considered in patients with suspected lung…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Structural and topological analysis of thiosemicarbazone-based metal complexes: computational and experimental study of bacterial biofilm inhibition and antioxidant activity
- Toward better cures for Mycobacterium abscessus lung disease
- Challenges for global antibiotic regimen planning and establishing antimicrobial resistance targets: implications for the WHO Essential Medicines List and AWaRe antibiotic book dosing
- Design, Synthesis and In vitro Antitubercular Effect of New Chalcone Derivatives Coupled with 1,2,3‐Triazoles: A Computational Docking Techniques
- Upregulation of pmrA, pmrB, pmrC, phoQ, phoP, and arnT genes contributing to resistance to colistin in superbug Klebsiella pneumoniae isolates from human clinical samples in Tehran, Iran
- Whole-genome sequencing of clinical isolates of Citrobacter Europaeus in China carrying blaOXA−48 and blaNDM−1
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.