Recurrent Respiratory Tract Infection in a 24-Year-Old Female Secondary to a Foreign Body Aspiration

Abstract

Foreign body aspiration (FBA) is a common problem necessitating prompt recognition and early treatment to minimize the potentially severe and sometimes fatal consequences. We presented a 24-year-old girl who was admitted for chronic cough and recurrent pneumonia associated with constitutional symptoms. She was feverish with a temperature of 39°C and had tachycardia and tachypnoea with an oxygen saturation of 98%. Investigations revealed leukocytosis. CXR showed right lower lobe consolidation, and CT thorax demonstrated collapse consolidation of the right middle and lower lobe, along with associated dilated segmental bronchioles and diffuse patch ground-glass opacity in both lung fields. Bronchoscopy revealed a pen cap at the entrance of the right lower lobe. Patient symptoms improved after removal of the foreign body. In patients with recurrent chest infection, the physician should check for the possibility of FBA and prompt for a referral to a tertiary center for further evaluation.

An unusual tracheal foreign body residing for 15 years: A case report and review of literature

“…4,5,7 Most of the foreign bodies in children are organic materials, and most of them lodge in one of the bronchi. 2,7,8 However, ours was a plastic material, lodged in proximal trachea. It is generally accepted that the longer a foreign body is in, the more distally it is likely to lodge.…”

“…An airway foreign body may be dealt with in a variety of ways, including flexible bronchoscopy, rigid bronchoscopy, tracheotomy/tracheostomy, thoracotomy/bronchotomy, and sometimes resection of a lobe damaged by a long‐standing object. 3 , 8 , 9 , 10 , 11 There have been reports of good success rates of removal via flexible bronchoscopy alone, especially in adults. 5 However (and especially in children), rigid bronchoscopy is generally considered the mainstay of treatment, and offers a direct vision and feel, good‐sized instrumentation, a chance to tamponade possible bleed, a step‐up for failed flexible bronchoscopy: all with a secured airway with ongoing ventilation.…”

“…Other unusual objects have included a capsule tinfoil, a Chinese herbal medicine, tooth, whistle, nasal ring and a piece of tin can, among others 4,5,7 . Most of the foreign bodies in children are organic materials, and most of them lodge in one of the bronchi 2,7,8 . However, ours was a plastic material, lodged in proximal trachea.…”

“…An airway foreign body may be dealt with in a variety of ways, including flexible bronchoscopy, rigid bronchoscopy, tracheotomy/tracheostomy, thoracotomy/bronchotomy, and sometimes resection of a lobe damaged by a long‐standing object 3,8–11 . There have been reports of good success rates of removal via flexible bronchoscopy alone, especially in adults 5 .…”