A 26-year-old man, a non-smoker, was admitted to the Veterans Administration Hospital, Dayton, Ohio, in May 1943 with complaints of nonproductive cough for 14 months, 13-kg (28-lb) weight loss over a nine-month period, pain in the left lower area of the chest, and fever. Physical examination disclosed a well-developed, fairly well-nourished white man who appeared moderately ill. Many teeth were carious. Tenderness, soft-tissue swelling, fistula, and dullness on percussion were noted over the left lower area of the chest wall. Tuberculin skin test was negative; smears and cultures of sputum and bronchial washings were negative for tubercle bacilli and fungi. Results of laboratory studies were within normal limits except for moderate leukocytosis. A posteroanterior chest roentgenogram (Fig 1) was obtained on admission. A roentgenogram of the lower left area of the rib cage was also obtained (Fig 2).
Actinomycosis of lung, pleura, and ribs.
Figure 1 shows
Kuo T, Gutman E. Lesion of the Lungs, Chest Wall, and Ribs. JAMA. 1974;230(7):1051–1052. doi:10.1001/jama.1974.03240070081044