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Actinomycotic infections

Infections of the pleural cavity with Actinomyces spp cause a pleural effusion and respiratory difficulty. Localised infection often found in the skin, any infection tends to be in combination with other bacteria. Infection can occur through inhalation, direct penetration via puncture wounds, or spread from another site in the body.

In cases of pleural effusion it presents as acute respiratory difficulty, this can be preceded in some cases by inappetance, weight loss and fever. Exercise can cause collapse. Xrays will show fluid in the chest which when drained appears cloudy and granular, this is sufficient for diagnosis.

Treatment involves draining the chest fluid and elimination of infection by antibiotic treatment. Tetracyclines or sulphonamides are suitable. As the problem develops it becomes more difficult to drain the fluid from the thorax. The prognosis is reasonable when treated early but worsens with disease progression.

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