Pulmonary Actinomycosis Induced by Total Gastrectomy and Heavy Alcohol Drinking: A Case Report.

Combined risk factors such as total gastrectomy, heavy alcohol consumption, smoking, and poor oral hygiene may contribute to the development of pulmonary actinomycosis. Here, we present a rare case of pulmonary actinomycosis triggered by total gastrectomy and heavy alcohol consumption. The patient presented with hemoptysis and a suspected lung mass. With a history of total gastrectomy and heavy alcohol consumption, the patient underwent imaging studies that initially suggested lung cancer. While imaging studies initially suggested lung cancer, multiple bronchoscopic examinations ultimately led to a diagnosis of pulmonary actinomycosis, following an initial biopsy that revealed chronic bronchitis. The patient was treated with oral amoxicillin (1,500 mg/day for six months) alongside comprehensive dental care, including periodontal therapy and dental restorations. This approach resulted in significant clinical improvement, with no recurrence of hemoptysis and favorable findings on chest X-ray. This case highlights the intricate interplay of risk factors in the development of pulmonary actinomycosis. It underscores the effectiveness of a multidisciplinary treatment strategy combining antibiotic therapy and dental care, which improved the patient's condition and avoided unnecessary interventions such as lung resection.