Diagnosis of a missed bronchial foreign body in an 8-year-old girl: a rare case report

Abstract

Tracheobronchial foreign body aspiration (TB-FBA) with subsequent airway obstruction typically occurs in children younger than 4 years. TB-FBA results in significant morbidity and mortality in children requiring urgent recognition and prompt management. Some cases remain more indolent and cause unusual respiratory insults ranging from chronic respiratory symptoms such as persistent cough, wheezing, and recurrent pneumonia to life-threatening airway obstruction. This case report presents a rare case of TB-FBA in an 8-year-old girl with a prolonged history of cough and dyspnea for 15 months despite many medical treatments and a rigid bronchoscopy examination performed by a board-certified pediatric surgeon. The patient was referred to Namazi Hospital's Pediatric Interventional Pulmonology Division where fiberoptic bronchoscopic exploration was conducted to remove a foreign body (a 6-cm wheat cluster) from the right lower lobe bronchus. This case report demonstrates the importance of clinical history in the diagnosis of aspirated foreign bodies despite unusual age and normal radiological findings.

A missed foreign body aspiration masquerading as congenital pulmonary airway malformation in a nine-year-old boy: A case report and literature review

“…Unfortunately, lack of history of choking or witness of FBA and the manifestation of CT scan compelled physicians of local hospital to make the provisional diagnosis of CPAM without a second thought, implying FBA is a deceptive condition and pointing out the importance of considering the possibility of a foreign body in the airway as an alternative. In short, FBA should be taken in consideration in any child with respiratory disorders even without a positive history and typical symptoms [ [8] , [9] , [10] ].…”

Chronic Cough and Causes in Children

“…Aspiration of foreign bodies can be retained and then can result in a persistent cough, often with wheezing. A dramatic case has been reported of an 8-year-old girl with a chronic cough that persisted for 15 months before a wheat sheaf was identified in a lower lobe bronchus of the right lung [ 11 ]. In a report on the late diagnosis of foreign body aspiration in children, a cough was the most frequent symptom, present in 29 of 32 children [ 12 ].…”