Endobronchial actinomycosis associated with nonorganic foreign body aspiration after years of latency.

A 35-year-old diabetic man was referred for nonresolving chronic cough of 3 months duration. Computed tomography scan revealed linear opacities in right upper lobe. A flexible bronchoscopy demonstrated a mass in the right upper lobe bronchus. An endobronchial biopsy of the lesion revealed granulation tissue and an actinomycotic infection. The patient did not respond to treatment for actinomycosis. He was subjected to thoracoscopic surgery and a small nonorganic foreign body covered in thick coat of actinomycosis was removed. The patient then responded to penicillin treatment. We report a case of nonorganic foreign body-induced endobronchial actinomycosis secondary to pen end cap aspirated during childhood.