{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:35Z","timestamp":1756339415150,"version":"3.44.0"},"reference-count":29,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,8,31]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p>\n                  <jats:italic>Actinomyces<\/jats:italic>, are gram-positive, non-spore forming anaerobic or microaerophilic species. Empyema due to actinomycosis is relatively rare and can be difficult to diagnose as the presenting symptoms may be indolent and the micro-organism may be difficult to culture. This case report describes a patient presenting with dyspnoea, weight loss and lethargy. The chest radiograph, CT and thoracic ultrasound revealed a left-sided pleural effusion. A chest drain was inserted under ultrasound guidance. The pleural fluid was macroscopically consistent with pus and microbiology showed growth of gram-positive bacilli, <jats:italic>Actinomyces meyeri<\/jats:italic> as well as the <jats:italic>Fusobacterium<\/jats:italic> species. The patient was treated with a drainage of the pleural fluid, a prolonged course of antibiotics and made a good recovery. The awareness that the <jats:italic>Actinomyces<\/jats:italic> species and the <jats:italic>Fusobacterium<\/jats:italic> species through their synergistic interaction may cause empyema, may lead to a timely diagnosis and treatment.<\/jats:p>","DOI":"10.1136\/bcr-2022-252867","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T12:20:14Z","timestamp":1694780414000},"page":"e252867","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Actinomycosis with <i>Fusobacterium<\/i> empyema"],"prefix":"10.1136","volume":"16","author":[{"given":"Christopher","family":"Sykes","sequence":"first","affiliation":[{"name":"Hull University Teaching Hospitals NHS Trust, Hull, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milan","family":"Barik","sequence":"additional","affiliation":[{"name":"Hull University Teaching Hospitals NHS Trust, Hull, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Kastelik","sequence":"additional","affiliation":[{"name":"Hull University Teaching Hospitals NHS Trust, Hull, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"2025082702191812000_16.9.e252867.1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S39601"},{"key":"2025082702191812000_16.9.e252867.2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01706-07"},{"key":"2025082702191812000_16.9.e252867.3","doi-asserted-by":"crossref","first-page":"35","DOI":"10.2147\/OAJC.S7476","article-title":"Female pelvic actinomycosis and intrauterine contraceptive devices","volume":"1","author":"P\u00e9rez-L\u00f3pez","year":"2010","journal-title":"OAJC"},{"key":"2025082702191812000_16.9.e252867.4","article-title":"Actinomyces Meyeri Empyema: a case report and review of the literature","volume":"2015","author":"Jung","year":"2015","journal-title":"Case Rep Infect Dis"},{"key":"2025082702191812000_16.9.e252867.5","doi-asserted-by":"crossref","DOI":"10.1164\/rccm.201108-1532CR","article-title":"Empyema necessitatis due to actinomyces Israelii","volume":"185","author":"Gupta","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"key":"2025082702191812000_16.9.e252867.6","doi-asserted-by":"publisher","DOI":"10.4103\/1817-1737.62470"},{"key":"2025082702191812000_16.9.e252867.7","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1097\/IPC.0b013e318169561d","article-title":"Pulmonary actinomycosis with Empyema","volume":"16","author":"Suri","year":"2008","journal-title":"Infectious Diseases in Clinical Practice"},{"key":"2025082702191812000_16.9.e252867.8","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.ijscr.2016.04.005","article-title":"Empyema necessitans caused by actinomycosis: a case report","volume":"23","author":"Atay","year":"2016","journal-title":"Int J Surg Case Rep"},{"key":"2025082702191812000_16.9.e252867.9","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.209.1.9769836"},{"key":"2025082702191812000_16.9.e252867.10","doi-asserted-by":"publisher","DOI":"10.1148\/rg.341135077"},{"key":"2025082702191812000_16.9.e252867.11","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.220.1.r01jl1376"},{"key":"2025082702191812000_16.9.e252867.12","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1148\/radiology.183.1.1549670","article-title":"Thoracic actinomycosis: CT findings in eight patients","volume":"183","author":"Kwong","year":"1992","journal-title":"Radiology"},{"key":"2025082702191812000_16.9.e252867.13","doi-asserted-by":"publisher","DOI":"10.1007\/s13244-012-0205-9"},{"key":"2025082702191812000_16.9.e252867.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2008.07.016"},{"key":"2025082702191812000_16.9.e252867.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2014.11.013"},{"key":"2025082702191812000_16.9.e252867.16","article-title":"Fusobacterium nucleatum Empyema: an atypical presentation","volume":"7","author":"Barrera-L\u00f3pez","year":"2020","journal-title":"Eur J Case Rep Intern Med"},{"key":"2025082702191812000_16.9.e252867.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.anaerobe.2004.06.001"},{"key":"2025082702191812000_16.9.e252867.18","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.cmi.2018.11.030","article-title":"The bacterial aetiology of pleural Empyema. 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