Introduction
Actinomycosis is a rare, indolent and invasive infection caused by Actinomyces species. These facultative anaerobic bacteria are constituents of the normal flora of the oropharynx, gastrointestinal tract and female genital tract. Actinomycosis develops when there is disruption of the mucosal barrier, invasion and systemic spread of the organism , which can lead to endogenous infection affecting numerous organs.
Actinomyces is known to spread in tissue through fascial planes and most often involves the cervicofacial (55%), abdominopelvic (20%) and thoracic (15%) soft tissue. Nevertheless the skin, central nervous system, pericardium and bone can also be affected. [1,2] Risk factors for actinomycosis in children include dental caries, trauma, debilitation, poorly controlled diabetes mellitus and foreign body aspiration. [3]
Pulmonary actinomycosis, very rarely seen in the paediatric population, can present with cough, fever, haemoptysis and weight loss. The classic radiological presentation of thoracic involvement of actinomycosis includes lower lobe consolidation, empyema and periostitis of the ribs. [4,5] We report a case of endobronchial pulmonary actinomycosis in a child diagnosed on endobronchial biopsy, taken during bronchoscopy.