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Case Reports in Critical Care
Volume 2013, Article ID 832306, 3 pages
http://dx.doi.org/10.1155/2013/832306
Case Report

A 75-Year-Old Female with Hemoptysis and Recurrent Respiratory Infections

1Pulmonary & Critical Care Medicine, Division of Pulmonary, Allergy, Critical Care Medicine, and Sleep Medicine, Indiana University School of Medicine, Gatch Clinical Building, Room 260, 541 N. Clinical Dr., Indianapolis, IN 46202-5111, USA
2Clinical Medicine, Division of Pulmonary, Allergy, Critical Care Medicine, and Sleep Medicine, Indiana University School of Medicine, 550 N. University Boulevard, UH 4903, Indianapolis, IN 46202, USA

Received 7 March 2013; Accepted 4 April 2013

Academic Editors: C. Diez, M. Egi, and J. Starkopf

Copyright © 2013 Mary S. Baker and Khalil Diab. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This paper describes the case of a 75-year-old female who presented with significant hemoptysis over a 7–10 day period. She had a history of a left lower lobectomy 10 years prior for a “lung abscess.” She subsequently had multiple episodes of cough, fevers, and possible pneumonia treated with multiple courses of Amoxicillin and Amoxicillin/Clavulanate. Review of her chest CT upon presentation to the hospital showed a large necrotic lingular infiltrate, which had been progressively increasing in size over at least one year. Bronchoscopy showed a yellowish, soft round body in the superior lingular subsegment. Endobronchial and transbronchial biopsies showed actinomyces species. This is a very interesting case of indolent actinomycosis which we suspect had a very slow progressive course secondary to the multiple courses of antibiotics that the patient was treated with.