OBJECTIVE To explore the clinical characteristics of actinomycosis so as to improve the early diagnosis and raise the cure rate.METHODS The clinical data of 5 patients with actinomycosis who were treated in Beijing Shijitan Hospital,Capital Medical University from Jan 2011 to Dec 2022 were retrospectively analyzed.RESULTS All the 5 patients were male,4 of whom had underlying diseases,4 had diabetes mellitus and poor control of blood glucose,2 had oral disease,1 had bronchiectasis,and only 1 case did not have any underlying disease but had long-term drinking history and presented drunken vomiting before onset of disease.1 case presented skin involve-ment and subcutaneous mass of chest wall;4 cases had lung involvement and were characterized by fever,cough,expectoration and hemoptysis.The result of chest CT examination showed that the cases mainly presented lung consolidation or infiltration,multiple nodules or block mass.3 patients were diagnosed with actinomycosis by tis-sue biopsy,1 patient was diagnosed with lung actinomycosis by sputum pathology,and 1 patient was diagnosed with lung actinomycosis by metagenomics next-generation sequencing(mNGS)examination of bronchoalveolar lav-age fluid.All the 5 patients received penicillins therapy,1 of whom received surgical procedure due to poor effect of penicillin therapy after 1 week,1 was complicated with fungal infection and received oral administration of itra-conazole.The illness condition of all the patients was improved after the treatment and was stable during follow-up.CONCLUSION Most of the actinomycosis patients have underlying diseases,especially diabetes mellitus,showing no specific clinical manifestations.The major findings of chest CT examination include the lung consolida-tion,nodules and mass.Tissue biopsy and mNGS may facilitate the early identification of actinomycosis.Penicillin is the first choice for the treatment,and surgical procedure is recommended if the therapeutic effect is poor.
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