Endobronchial mucosal nodules and actinomycosis in a child with
activated phosphatidylinositol 3-kinase delta syndrome (APDS)
A 5-year-old girl had poor growth and unresolving pneumonia. There was
persistent collapse-consolidation of the right middle lobe. CT thorax
revealed bilateral bronchial wall thickening and dilatation.
Bronchoscopy showed numerous endobronchial mucosal nodules, consisting
of dense lymphoid infiltrates. Bacterial culture of the nodule biopsy
suggested endobronchial actinomycosis. She had T-cell lymphopenia.
Genetic test confirmed the diagnosis of activated phosphatidylinositol
3-kinase delta syndrome (APDS), an immunodeficiency condition.