Foreign Body Aspiration Presenting as Pneumothorax in a Child
Maxwell D Newby1, David Thomas2, Charles J Mullett2
1Otolaryngology, West Virginia University, Morgantown, USA.
Insights
Foreign body aspiration (FBA) in children can lead to rare but serious complications like pneumothorax. Early recognition and prompt treatment are crucial for managing this potentially life-threatening condition.
Area of Science:
- Pediatrics
- Pulmonology
- Emergency Medicine
Background:
- Foreign body aspiration (FBA) in children typically presents with acute respiratory symptoms.
- Pneumothorax as a complication of FBA is uncommon but requires immediate medical intervention.
Observation:
- A 17-month-old female developed pneumothorax during hospitalization for respiratory syncytial virus (RSV) bronchiolitis.
- The pneumothorax was linked to a cashew fragment aspirated two weeks prior to admission.
Findings:
- This case highlights a rare secondary complication of FBA.
- The patient's delayed presentation of pneumothorax underscores the importance of considering FBA even with initial diagnoses like RSV bronchiolitis.
Implications:
- The findings suggest a potential risk associated with current guidelines recommending early introduction of allergenic foods, such as peanuts, to infants.
- Clinicians should maintain a high index of suspicion for FBA in children with unexplained respiratory distress, even after initial diagnosis and treatment.
Abstract:
A typical presentation of a foreign body aspiration (FBA) in a child includes witnessed choking, respiratory distress, cyanosis, coughing, wheezing, diminished breath sounds, and/or altered mental status. Following an extensive literature review, we found pneumothorax occurring secondary to FBA is a rare occurrence and should elicit prompt treatment. This 17-month-old female was admitted for respiratory syncytial virus (RSV) bronchiolitis and developed a subsequent pneumothorax during her hospital stay, consequent to aspiration of a cashew fragment two weeks before presentation. In light of the National Institute of Allergy and Infectious Diseases (NIAID)-sponsored expert panel's addended guidelines, published and endorsed by the American Academy of Pediatrics (AAP) in 2017, we highlight a potential complication of increasing encouragement of peanut consumption in children as young as four months.
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