ObjectiveTo improve the knowledge of pulmonary actinomycosis. MethodsOne case of pulmonary actinomycosis with positive blood culture diagnosed on December 2013 in North Huashan Hospital was analyzed,and related literature from CNKI and Medline after 1990 were reviewed. ResultsA 57-year-old male had recurrent fever for 24 days.Chest CT showed pneumonia in the right middle lobe.Actinomyce culture was twice positive by anaerobic blood culture.The patient's temperature was normal after large doses of penicillin and doxycycline therapy.Literature review revealed that the incidence of pulmonary actinomycesis is common in males.Poor oral hygiene is the main predisposing factors.The common clinical presentations include cough,sputum production,chest pain and hemoptysis.The peripherally progressive enhancement on CT has a certain diagnostic value for pulmonary actinomycosis.Pulmonary actinomycosis can increase FDG uptake on 18F-FDG PET scan and can mimic lung cancer.Accurate diagnosis is generally made by histopathological examination of lung biopsy or surgical samples.High-dose intravenous penicillin therapy is preferred for pulmonary actinomycosis followed by prolonged oral antibiotics for 6 to 12 months.Surgical intervention may be necessary for refractory hemoptysis or patients who do not respond to antibiotic therapy. ConclusionPulmonary actinomycosis is a rare disease.Symptoms of pulmonary actinomycosis are atypical.This patient is the first reported case of actinomyces with positive blood cultures.