Madsen Anne, Madsen Poul Henning
Department of Medicine, Division of Respiratory Medicine, Littlebaelt Hospital, Fredericia / Vejle, Denmark.
BMJ Case Rep. 2014 Jul 3;2014:bcr2013201959. doi: 10.1136/bcr-2013-201959.
Endobronchial foreign body is a well-known but rare diagnosis when encountering adult patients with unexplained recurring pneumonias. Often, the symptoms are subtle and can be mistaken for other more common conditions. A high degree of clinical suspicion is essential in diagnosing these patients. In the presented case of recurrent pneumonia and prolonged coughing, an endobronchial foreign body was revealed several months after the aspiration when a thorough medical history was taken. An almond was found by flexible bronchoscopy and removed by emergency rigid bronchoscopy; the symptoms later resolved. We discuss the importance of taking a thorough medical history, which in many cases is the clue to correct diagnosis and treatment. In addition, we discuss the diagnostic workup and therapy in cases of endobronchial foreign bodies.
当遇到患有不明原因复发性肺炎的成年患者时，支气管内异物是一种广为人知但却罕见的诊断。通常，症状很细微，可能会被误诊为其他更常见的病症。对这些患者进行诊断时，高度的临床怀疑至关重要。在本病例中，患者出现复发性肺炎和持续性咳嗽，在详细询问病史数月后发现了支气管内异物。通过纤维支气管镜检查发现了一颗杏仁，并通过急诊硬质支气管镜将其取出；症状随后得到缓解。我们讨论了详细询问病史的重要性，在许多情况下，这是正确诊断和治疗的线索。此外，我们还讨论了支气管内异物病例的诊断检查和治疗方法。
