Forgotten Foreign Body Aspiration Presenting as Allergic Bronchopulmonary Aspergillosis: A Case Report

The usual presentation of foreign body (FB) aspiration into the tracheobronchial tree is a choking sensation followed by recurrent respiratory symptoms. Without a definitive history, the diagnosis of FB aspiration can be challenging. Here, we present a case of a 40-year-old male who presented with recurrent episodes of blood-stained sputum over the past six years. Contrast-enhanced computed tomography of the chest and serological investigations suggested allergic bronchopulmonary aspergillosis. Video bronchoscopy was performed for the hemoptysis workup, which identified and retrieved a plastic pen cap from the right lower lobe bronchus. On questioning, the patient disclosed a history of FB aspiration 20 years ago. Because he did not develop any immediate symptoms, he assumed that he probably swallowed the FB and never divulged it.