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Not all wheeze is asthma: A case of central airway foreign body mimicking asthma
1Hospital Sultanah Bahiyah, Jalan Langgar, Alor Setar, Malaysia.
Insights
Foreign body aspiration, though common in children, can affect the elderly due to impaired reflexes. A betel nut lodged in an elderly woman
Area of Science:
- Medicine
- Pulmonology
- Geriatrics
Background:
- Foreign body aspiration is more prevalent in pediatric patients but can occur in older adults.
- Impaired airway protective mechanisms or absent swallowing reflexes in the elderly increase aspiration risk.
- Conditions like neurological diseases, head trauma, intoxication, sedation, or dental procedures can precipitate aspiration in seniors.
Observation:
- An elderly woman presented with symptoms initially misdiagnosed as respiratory tract infection and asthma.
- These symptoms were attributed to a foreign body lodged in her airway.
- The persistent symptoms suggested a chronic underlying issue rather than acute infection or asthma.
Findings:
- A betel nut was identified as the foreign body causing airway obstruction in the elderly patient.
- Bronchoscopy was crucial for diagnosing the presence of the betel nut.
- Surgical removal of the betel nut via bronchoscopy led to complete symptom resolution.
Implications:
- This case highlights the importance of considering foreign body aspiration in elderly patients with persistent respiratory symptoms.
- Delayed diagnosis of foreign body aspiration in the elderly can lead to prolonged illness and misdiagnosis.
- Prompt bronchoscopic evaluation and removal are effective treatments for airway obstruction caused by foreign bodies in geriatric patients.
Abstract:
Foreign body aspirations are more commonly seen in the paediatric age as compared to adults. This is more widely seen in the older population due to the impairment of protective airway mechanisms or the absence of the swallowing reflex, for instance, in neurological diseases, head trauma, alcohol intoxication, sedation, or complications from dental manipulation. We report the case of a betel nut causing airway obstruction in an elderly lady, which was treated multiple times as respiratory tract infection and asthma. Subsequently, a bronchoscopy was performed. Following which, the betel nut was removed causing resolution of symptoms.
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