Pulmonary actinomycosis. A cause of endobronchial disease in a patient with AIDS.

We report a case of a 47-year-old man with AIDS who presented with fever, cough and a lingular infiltrate. Flexible fiberoptic bronchoscopy revealed an endobronchial exophytic mass with extensive purulent exudate which on Gram stain and cytology from bronchial washings revealed Actinomyces infection. There was a clinical response to penicillin therapy, and on repeat bronchoscopic examination, there was a partial resolution of the endobronchial infection. To our knowledge, this is the first known case of endobronchial pulmonary actinomycosis in a patient with AIDS.