Empyema caused by foreign body aspiration

Gharabaghi, Mehrnaz Asadi; Gharabaghi, Mehrnoush Asadi; Shahram, Farhad

doi:10.1136/bcr-2012-007760

Cited by 6 publications

(9 citation statements)

References 2 publications

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“…Additionally, an extended period of time may be required for empyema to develop as a result of FB aspiration. In our case, empyema developed after the patient had inhaled a foreign body only three months earlier, which was faster than the 8 months to 4 years (Dilege et al 2002 ; Asadi Gharabaghi et al 2012 ) or even > 30 years (Schembri et al 2003 ) reported in previous studies. In addition, our patient developed a whole right-side empyema, rather than a local empyema described in previous cases (Dilege et al 2002 ; Behl et al 2008 ; Asadi Gharabaghi et al 2012 ; Schembri et al 2003 ).…”

Section: Discussionsupporting

confidence: 44%

“…In the largest study of FB aspiration ever conducted in adults, the most frequently reported complications were granulation formation (76.5%), obstructive pneumonia (22.0%), bleeding (14.5%), atelectasis (10.0%) and endobronchial stenotic scarring (8.0%) (Dong et al 2012 ). Only a few cases of non-iatrogenic FB-induced empyema have been reported (Ota and Kawai 2012 ; Dilege et al 2002 ; Behl et al 2008 ; Asadi Gharabaghi et al 2012 ; Schembri et al 2003 ). Similar to other long-term complications, the major symptoms displayed by adults with FB-induced empyema include a productive cough, fever, chest pain, shortness of breath, and dyspnea (Ota and Kawai 2012 ; Dilege et al 2002 ; Behl et al 2008 ; Asadi Gharabaghi et al 2012 ; Schembri et al 2003 ).…”

Section: Discussionmentioning

confidence: 99%

“…Only a few cases of non-iatrogenic FB-induced empyema have been reported (Ota and Kawai 2012 ; Dilege et al 2002 ; Behl et al 2008 ; Asadi Gharabaghi et al 2012 ; Schembri et al 2003 ). Similar to other long-term complications, the major symptoms displayed by adults with FB-induced empyema include a productive cough, fever, chest pain, shortness of breath, and dyspnea (Ota and Kawai 2012 ; Dilege et al 2002 ; Behl et al 2008 ; Asadi Gharabaghi et al 2012 ; Schembri et al 2003 ). Additionally, an extended period of time may be required for empyema to develop as a result of FB aspiration.…”

Section: Discussionmentioning

confidence: 99%

“…Although the clinical manifestations and management of foreign body (FB) aspiration in children and adults have been well summarized in several previous case series (Baharloo et al 1999 ; Dong et al 2012 ; Nguyen et al 2011 ), pleural infection following inhalation of a non-iatrogenic FB is a very rare complication, and only a few case relevant case reports have been published (Ota and Kawai 2012 ; Dilege et al 2002 ; Behl et al 2008 ; Asadi Gharabaghi et al 2012 ; Schembri et al 2003 ). Acute onset of respiratory distress and severe sepsis caused by empyema after inhalation of a foreign body has never been reported.…”

Section: Introductionmentioning

confidence: 99%

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Empyema, acute respiratory failure, and septic shock after aspiration of a soft-shelled turtle (Pelodiscus sinensis) bone by an adult

Zhang

et al. 2014

SpringerPlus

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IntroductionThe common late complications of foreign body aspiration include granulation formation, obstructive pneumonia, and atelectasis. However, a foreign body-induced pleural infection is very rare, and especially when it is not iatrogenic.Case descriptionA 64-year-old Chinese man was admitted to our hospital with septic shock and acute respiratory failure requiring intubation and mechanical ventilation. Computed tomography revealed multiloculated pleural effusion on the whole right side and right lung atelectasis, with enhanced thickening and calcification of pleura and a foreign body in the right intermediate bronchus. The effusion appeared as a cloudy fluid consistent with pus. A bedside bronchoscopy revealed an irregular foreign body lodged in the right intermediate bronchus. The hard bone was removed and confirmed to be a soft-shelled turtle bone. A final diagnosis of foreign body-induced empyema, acute respiratory failure, and septic shock was confirmed. The patient showed good recovery after completing a course of broad-spectrum antibiotics and undergoing chest tube drainage.Discussion and evaluationAlthough empyema has been reported previously as a rare complication of long-term retention of an aspirated foreign body, no case has been observed that was as serious as our current patient. In addition, a foreign body aspiration by a soft-shelled turtle bone was never reported before.ConclusionsFor the first time, we describe the successful treatment of an adult patient presenting with empyema, accompanied by serious conditions of acute respiratory failure and septic shock induced by aspiration of a soft-shelled turtle bone. Clinicians should consider the possibility of non-iatrogenic foreign body-induced empyema with acute onset of respiratory failure, when a patient’s symptoms cannot be attributed to an alternative obvious cause.

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Section: Discussionsupporting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Empyema, acute respiratory failure, and septic shock after aspiration of a soft-shelled turtle (Pelodiscus sinensis) bone by an adult

Zhang

et al. 2014

SpringerPlus

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“…Postobstructive pneumonitis as a consequence of FBA with secondary empyema is rare but well reported 1. Indeed, FBA has generated numerous case reports—a recent meta-analysis counted over 200 paediatric reports 2.…”

Section: Discussionmentioning

confidence: 99%

Empyema thoracis from an inhaled peanut

Hinchion

O’Connor²

2014

BMJ Case Reports

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SUMMARYA 77-year-old man with a history of pulmonary sarcoidosis was referred with persistent cough and reduced air entry on auscultation of the right lung base. He was an ex-smoker with a 40-pack-year history and his general practitioner was concerned about the possibility of bronchogenic carcinoma. A chest radiograph showed a right-sided pleural effusion with right mid-zone airspace opacification. Bronchoscopy revealed a peanut covered in mucus lodged in the right lower lobe bronchus. CT of the thorax demonstrated a multiloculated right pleural effusion with associated compressive atelectasis, consistent with chronic empyema. A chest drain was inserted but failed to fully clear the collection and the patient proceeded to a thoracoscopic decortication of a pleural empyema secondary to the right lower lobe obstruction from an inhaled peanut. His postoperative recovery was uncomplicated. BACKGROUND

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