Müller R, Schmidt M, Müller K M, Breuer H W
Abteilung Innere Medizin, St.-Carolus-Krankenhaus Görlitz.
Pneumologie. 1999 Jul;53(7):360-3.
Undetected foreign body aspiration is a well-known problem not only in children and patients with predisposing conditions like mental retardation, seizures or brain tumours, but also in healthy subjects. The clinical signs are quite different. Haemoptysis, cough, recurrent or chronic penumonia and bronchitis may occur. These symptoms are often accompanied by fever, weight loss and night sweat. Atelectasis, respiratory distress or death have been described. We demonstrate the case of a 39-year old man with Down syndrome who was transferred to our hospital because of pneumonia in the left lower lobe that had been lasting for about two months. It had been resistant to several antibiotic regimens. Computerised tomography led to the suspicion of a bronchial carcinoma with poststenotic infiltration of the lower lobe. Fibreoptic bronchoscopy and biopsy confirmed the diagnosis of a foreign body in the distal part of the left main bronchus. After two weeks of treatment with ciprofloxacin regression of the acute inflammation occurred. During a second bronchoscopy we could extract the foreign body (a 1 x 1.7 cm vertebra of a dove). It is concluded that undetected foreign body aspiration can occur in various clinical settings and fibreoptic bronchoscopy is a suitable approach providing an exact diagnosis.
未被发现的异物吸入是一个众所周知的问题，不仅在儿童以及患有诸如智力迟钝、癫痫或脑肿瘤等易感疾病的患者中存在，在健康受试者中也会出现。临床症状差异很大。可能会出现咯血、咳嗽、反复或慢性肺炎及支气管炎。这些症状常伴有发热、体重减轻和盗汗。也曾有肺不张、呼吸窘迫或死亡的报道。我们展示了一名39岁唐氏综合征男性患者的病例，该患者因左肺下叶肺炎持续约两个月而被转至我院。该肺炎对多种抗生素治疗方案均有耐药性。计算机断层扫描怀疑为支气管癌伴下叶狭窄后浸润。纤维支气管镜检查及活检确诊左主支气管远端有异物。使用环丙沙星治疗两周后，急性炎症消退。在第二次支气管镜检查时，我们取出了异物（一块1×1.7厘米的鸽子椎骨）。结论是，未被发现的异物吸入可发生在各种临床情况下，纤维支气管镜检查是提供准确诊断的合适方法。
