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Pleural effusion as a rare presentation of foreign body aspiration

Shouichi Okamoto1, Mikio Takamori2, Miake Yamamoto2

  • 1Division of Respiratory Medicine, Juntendo University Faculty of Medicine & Graduate School of Medicine, Tokyo, Japan.

Respiratory Medicine Case Reports
|August 17, 2021
PubMed

Insights

Aspirated foreign bodies, like iron pills, can mimic pneumonia or heart failure. Suspect aspiration if initial treatments fail, as it can lead to fatal obstructive pneumonia.

Area of Science:

  • Pulmonology
  • Internal Medicine
  • Geriatrics

Background:

  • Foreign body aspiration often presents with non-specific respiratory symptoms.
  • It can be misdiagnosed as common respiratory or cardiovascular conditions.

Observation:

  • An 82-year-old male presented with persistent pleural effusion despite heart failure treatment.
  • Symptoms included productive cough and low-grade fever, leading to thoracentesis and CT scan.

Findings:

  • Thoracentesis revealed an exudative effusion.
  • A pill-like object, identified as an iron pill, was found in the right bronchus intermedius.
  • The patient developed fatal obstructive pneumonia due to pill-induced mucosal damage.

Implications:

  • Foreign body aspiration should be considered in cases of unresolved or atypical respiratory symptoms, even when mimicking cardiovascular disease.
  • Delayed diagnosis of foreign body aspiration can lead to severe complications, including fatal pneumonia.
  • This case highlights the importance of considering foreign body aspiration in the differential diagnosis of elderly patients with persistent respiratory or pleural abnormalities.
Keywords:
AspirationBronchoscopyFBA, foreign body aspirationForeign bodyIron pillNT-proBNP, elevated N-terminal pro-B-type natriuretic peptide.Pleural effusion

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