Late diagnosis of bronchial foreign body aspiration in a 14-year-old teenager

Abstract

T.A. Bokova1,2, E.S. Vakurova1, A.N. Verbovsky1, A.S. Bevz1, A.R. Temendarov1, O.A. Bokova1 1M.F. Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow, Russian Federation 2Pirogov Russian National Research Medical University, Moscow, Russian Federation The article describes a clinical case of late-diagnosed bronchial foreign body aspiration in a 14-year-old girl. The unusual clinical course and patient’s complaints, the lack of primary care physicians’ awareness caused the diagnostic delay and underpinned the initial misdiagnosis (pneumonia, acute tracheitis, bronchitis, lung abscess, TB-infection suspicion). The diagnostic errors led to the improper case management and the unjustified administration of repeated courses of antibiotics, and multiple X-ray examinations. Bronchoscopy which helped to make the final diagnosis and allowed removing the foreign body from the bronchus, was performed only nine months after the onset of clinical symptoms and patient’s complaints. The article is discussing all stages of diagnostic process, both during outpatient follow-up and in hospital settings. The emphasis is put on the importance of collecting patient’s health history which led to the suspicion for an airway foreign body. The bronchoscopy tactics are described as the main diagnostic and therapeutic method for identifying and removing a foreign body from the respiratory tract. Based on the appropriate sequence of steps and the accuracy of manipulation, all bronchoscopy stages were completed without complications, and all clinical symptoms relieved. Keywords: foreign body, children, tracheobronchial tree, bronchoscopy, lavage. For citation: Bokova T.A., Vakurova E.S., Verbovsky A.N. et al. Late diagnosis of bronchial foreign body aspiration in a 14-year-old teenager. Russian Journal of Woman and Child Health. 2022;5(3):277–283 (in Russ.). DOI: 10.32364/2618-8430-2022-5-3-277-283.