27 September 2026
: Case report 
Pulmonary Actinomycosis Diagnosed via BALF mNGS in a 53-Year-Old Nonsmoking Man With Pneumoconiosis and Penicillin-Induced Thrombocytopenia: A Case Report
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Adverse events of drug therapy, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Xin Feng BE 1, Lin-yu Wang
CE 2, Ni-jiao Li DE 1, Ze-qiang Lin F 1, He-ming Huang F 1, Yi-ling Xie F 1, Jie Liang F 1, Lunkai Yao F 1, Xin-yi Zhuo F 1, Yan Li DF 2*, Ye Qiu AG 1
DOI: 10.12659/AJCR.953438
Am J Case Rep 2026; 27:e953438
Table 1 Naranjo scale.
| No. | Question | Score | ||||
|---|---|---|---|---|---|---|
| Yes | No | Do Not Know | Ampicillin/Sulbactam | Penicillin G | ||
| 1 | Are there previous conclusive reports of this reaction? | 0 | 0 | +1 | +1 | |
| 2 | Did the adverse event appear after the suspected drug was administered? | −1 | 0 | +2 | +2 | |
| 3 | Did the adverse event improve when the drug was discontinued or a specific antagonist was administered? | 0 | 0 | +1 | +1 | |
| 4 | Did the adverse event reappear when the drug was readministered? | +2 | −1 | 0 | 0 | |
| 5 | Could alternative causes have caused the reaction on their own? | −1 | +2 | 0 | +2 | +2 |
| 6 | Did the reaction reappear when a placebo was given? | −1 | +1 | 0 | 0 | |
| 7 | Was the drug detected in blood or other fluids at concentrations known to be toxic? | +1 | 0 | 0 | 0 | |
| 8 | Was the reaction more severe when the dose was increased or less severe when the dose was decreased? | +1 | 0 | 0 | 0 | |
| 9 | Did the patient have a similar reaction to the same or similar drugs during any previous exposure? | 0 | 0 | +1 | +1 | |
| 10 | Was the adverse event confirmed by any objective evidence? | 0 | 0 | +1 | +1 | |
| ≥ | Definite | |||||
| Possible | ||||||
| Doubtful | ||||||