Conclusion
We present a rare case of advanced endobronchial actinomycosis in a
child . We postulate that dental caries were the source of the
infection, which led to micro aspiration of the pathogen. We postulate
that there was delay in referral and diagnosis due to the SARS-CoV-2
pandemic. . This case highlights the difficulty in diagnosis of rare
lung conditions in high incidence settings of tuberculosis, particularly
where there is limited access to specialised pulmonology, infectious
diseases and microbiology services. The diagnosis in this case was made
on BAL. Bronchoscopy can be dangerous when performed on these cases, as
there is a risk of severe bleeding and large airway obstruction, as was
the case with this patient.