[Diffuse aspiration bronchiolitis in an elderly woman]

A 74-year-old woman was admitted to the hospital because of persistent nocturnal coughing and abnormal shadows on chest x-ray films. The films showed cavities in the right upper lobe and small nodular shadows in the right upper, lower, and left upper lung fields. Examination of a specimen obtained by transbronchial lung biopsy showed nonspecific inflammatory changes. An open-lung biopsy was done. Histopathological examination showed evidence of diffuse aspiration bronchiolitis and actinomyces. Actinomyces is a member of the endogenous flora of the oral mucous membranes. Our diagnosis was diffuse aspiration bronchiolitis caused by micro-aspiration of oro-pharyngeal secretions during sleep.