{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T19:23:35Z","timestamp":1750533815226,"version":"3.40.4"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,8,31]]},"abstract":"<jats:p>We present a patient with advanced Hodgkin's disease treated with escalated BEACOPP chemotherapy. The result from the interim fluorodeoxyglucose positron emission tomography with CT (PET-CT) after two cycles of chemotherapy is crucial for treatment guidance for the clinical trial HD18 from the German Hodgkin Study Group. An increase in size and standard uptake value (SUV) of a pulmonary lesion suggesting refractory Hodgkin's disease was documented. Since all other manifestations of the lymphoma responded well to the treatment, the discordant behaviour was suspicious for another reason for this progressive pulmonary lesion. Bronchoscopy revealed Actinomyces species in cultures from bronchial washings. Specific treatment was initiated and consisted of 2\u2005weeks of intravenous penicillin followed by ceftriaxone intravenous for another 4\u2005weeks and subsequent oral amoxicillin to complete 12\u2005months of antibiotic therapy. For the Hodgkin's lymphoma, complete remission was documented after a total of six cycles of escalated BEACOPP.<\/jats:p>","DOI":"10.1136\/bcr-2014-206034","type":"journal-article","created":{"date-parts":[[2014,9,22]],"date-time":"2014-09-22T11:03:00Z","timestamp":1411383780000},"page":"bcr2014206034","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Pulmonary actinomycosis and Hodgkin's disease: when FDG-PET may be misleading"],"prefix":"10.1136","volume":"2014","clinical-trial-number":[{"clinical-trial-number":"nct00515554","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct00515554","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"C","family":"Weisshaupt","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Hitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W C","family":"Albrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Omlin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,9,22]]},"reference":[{"key":"2025042706341840000_2014.sep22_1.bcr2014206034.1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr378"},{"key":"2025042706341840000_2014.sep22_1.bcr2014206034.2","first-page":"482","article-title":"Position emission tomography with or without computed tomography in the primary staging of Hodgkin's lymphoma","volume":"91","author":"Hutchings","year":"2006","journal-title":"Haematologica"},{"key":"2025042706341840000_2014.sep22_1.bcr2014206034.3","unstructured":"Southwick F . Pulmonary infections, rarer causes of community-acquired pneumonia, actinomycosis. In: Southwick F , ed. Infectious diseases a clinical short course. 2nd edn. McGraw-Hill Companies, 2008:99."},{"key":"2025042706341840000_2014.sep22_1.bcr2014206034.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00089103"},{"key":"2025042706341840000_2014.sep22_1.bcr2014206034.5","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-216"},{"key":"2025042706341840000_2014.sep22_1.bcr2014206034.6","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.075150"},{"key":"2025042706341840000_2014.sep22_1.bcr2014206034.7","unstructured":"Russo TA . Agents of actinomycosis. In: Mandell G, Bennett J, Dolin R, eds. Mandell, Douglas and Bennett's principles and practice of infectious diseases. 6th edn. New York: Elsevier\/Churchill Livingstone, 2005:2924\u201331."},{"key":"2025042706341840000_2014.sep22_1.bcr2014206034.8","unstructured":"Horning SJ . Hodgkin lymphoma. In: Cavalli F Kaye SB Hansen HH Armitage JO , eds. Textbook of medical oncology. 4th edn. 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