The Non-Innoculous Hilar Calcification: Recurrent Pneumonia Secondary to Broncholith-Associated Actinomyces

Dystrophic calcification of hilar lymph nodes is a common response to chronic inflammation related to several etiologies and rarely is associated with any clinical findings. A clinical scenario related to these calcified lymph nodes can thus be delayed by the low clinical suspicion associated with such a presumably innocuous finding. Normal respiratory movements however, can cause erosion into adjacent bronchi leading to a broncholith, complications of which can result in morbidity. We illustrate one of these complications, a partial obstruction with subsequent recurrent infection due to normal oral flora - actinomyces.