Pulmonary actinomycosis with large cavitation in an alcoholic 39-year-old man

A 39-year-old man with a history of alcohol and tobacco abuse was admitted after experiencing 1 month of productive cough, night sweats, mild dyspnoea and weight loss. Physical examination revealed alteration of general state (45 kg, loss of 15 kg), mild fever (38°C) and low oxygen saturation (88%). HIV serology testing was negative. Chest X-ray and CT scan showed right upper lobe cavitation (figure 1A, B). Bronchoalveolar lavage (BAL) was performed …