Pediatric foreign body aspiration: A nidus for Aspergillus colonization

Area of Science:

• Pediatric Pulmonology
• Mycology
• Respiratory Medicine

Background:

• Foreign body aspiration is a common cause of respiratory distress in children.
• Fungal infections, such as aspergillosis, can occur in the airways, particularly in immunocompromised individuals.
• The role of foreign bodies as a nidus for fungal colonization in immunocompetent children is not well-established.

Observation:

• A two-year-old immunocompetent male presented with persistent cough.
• Bronchoscopy revealed aspirated foreign material in the right mainstem bronchus.
• Histopathology of the adjacent bronchial mucosa showed fungal organisms, consistent with Aspergillus, within an ulcer.

Findings:

• This case represents the first documented instance in pediatric literature of bronchial aspergillosis secondary to foreign body aspiration in an immunocompetent child.
• The aspirated foreign material served as a substrate for fungal proliferation within the bronchus.
• The presence of fungal organisms was associated with bronchial mucosal ulceration.

Implications:

• Bronchial foreign bodies may represent a significant risk factor for fungal colonization and infection in otherwise healthy children.
• Clinicians should consider fungal infection in the differential diagnosis of persistent respiratory symptoms following foreign body aspiration in pediatric patients.
• Further research is warranted to elucidate the mechanisms and prevalence of fungal colonization associated with pediatric airway foreign bodies.