[Skip to Content]
[Skip to Content Landing]
November 18, 1974

Lesion of the Lungs, Chest Wall, and Ribs

Author Affiliations

From the Department of Radiology, Veterans Administration Center, Dayton (Drs. Kuo and Gutman), and the Department of Radiology, Ohio State University College of Medicine, Columbus (Dr. Gutman), Ohio.

JAMA. 1974;230(7):1051-1052. doi:10.1001/jama.1974.03240070081044

History:  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).

Diagnosis  Actinomycosis of lung, pleura, and ribs.

Comment  Figure 1 shows