Aspiração de corpo estranho: sempre um diagnóstico diferencial em lactentes

Abstract

OBJECTIVE: To describe the atypical development of a severe case of foreign body aspiration involving a pediatric patient. INTRODUCTION: Foreign body aspiration is an important cause of morbidity and mortality in the pediatric age group. Cases range from asymptomatic to patients developing acute respiratory failure. Although difficult to identify, cases suspected with foreign body aspiration must be investigated thoroughly. CASE REPORT: A one-year-old male infant was brought to our service after presenting with dyspnea for 48 hours and unmeasured fever. During the interview, the possibility of foreign body aspiration was considered. A chest X-ray was performed, with no findings. The patient was sent to a referral hospital for further investigation. During transport, the patient developed respiratory failure. Upon arrival, initial stabilization measures were taken, and the patient underwent a second chest X-ray, which showed opacification of the left hemithorax with mediastinal deviation, along with atelectasis of the left lung and hyperinflation of the right lung. The patient was intubated and emergency bronchoscopy was performed, which revealed a foreign body (corn) in the left bronchus. After removal, a new radiograph was taken and the condition resolved completely. The patient remained hospitalized for treatment of pneumonia caused by complications from the presence of the foreign body. CONCLUSION: This report aims to emphasize the possible complications ensuing from foreign body aspiration and the need to consider it even when radiological findings are not compatible, as was initially the case. Moreover, as a public health measure, we seek to reinforce prevention measures in order to decrease the number of cases such as the one described in this report.

Keywords

• child
• aspiration
• foreign body reaction
• respiratory failure