A Chronic Lung Cavity Concealing an Unsuspected Foreign Body Aspiration in a Child

Area of Science:

• Pediatric Pulmonology
• Thoracic Surgery
• Pediatric Emergency Medicine

Background:

• Delayed foreign body aspiration (FBA) is an uncommon cause of lung abscesses in pediatric patients.
• Children presenting with persistent respiratory symptoms and lung lesions may have an undiagnosed FBA.
• A case of a 3-year-old girl with a cavitary lung lesion initially diagnosed as a lung abscess is presented.

Purpose of the Study:

• To highlight the importance of considering occult foreign body aspiration in pediatric patients with lung abscesses.
• To emphasize the diagnostic value of bronchoscopy in cases unresponsive to antibiotic treatment.
• To present a case report illustrating the successful management of delayed FBA.

Main Methods:

• A 3-year-old girl with symptoms of fever, cough, and a cavitary lung lesion was evaluated.
• Initial treatment with antibiotics for suspected lung abscess was ineffective.
• Bronchoscopy was performed, revealing a pumpkin seed shell fragment causing airway obstruction and granulation.

Main Results:

• Bronchoscopic removal of the foreign body was successful.
• The patient experienced a full recovery after the intervention.
• The underlying cause of the cavitary lung lesion was identified as an aspirated pumpkin seed shell.

Conclusions:

• Occult foreign body aspiration should be a differential diagnosis in children with focal cavitary lung lesions.
• In pediatric cases of lung abscess unresponsive to antibiotics, bronchoscopy is recommended for definitive diagnosis and treatment.
• Early identification and removal of aspirated foreign bodies are critical for favorable patient outcomes.