A Bronchopleurocutaneous Fistula Caused by Unexpected Foreign Body Aspiration: False Barley (Hordeum murinum)

A 13-year-old boy with no previous history of foreign body aspiration, presenting with side pain, was referred to our clinic with a pneumonia diagnosis by an external medical facility where he had been started on antibiotic treatment. Consolidation in the right inferior lobe and minimal pleural effusion were found on the lung radiograph and computed tomography scan. Skin hyperemia and abscess formation in the right chest were observed subsequently. A drain was placed; bronchoscopy, sampling for cultures, and a biopsy were performed. Four months after this first episode ended with inconclusive results, the patient returned, reporting that a spike of grass was protruding from the continued abscess drainage. The skin lesion closed after emptying of the abscess cavity; a check-up bronchoscopy was unremarkable. The extrusion from the skin of the foreign body, a rare event in the published literature, was our first such case.