De Wilde Belphine A L, Malfait Thomas L, Bonte Katrien, Malfait Thomas L A
a Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium.
b Department of Nephrology , Ghent University Hospital , Ghent , Belgium.
Acta Clin Belg. 2016 Dec;71(6):444-447. doi: 10.1080/17843286.2016.1153213. Epub 2016 May 3.
We present a case of a 66-year-old Caucasian man with acute respiratory distress. The patient had a history of multiple cerebrovascular accidents which resulted in left hemiplegia, swallowing problems, and aphasia. He was tentatively diagnosed with aspiration pneumonia. However, because of clinical deterioration further investigations concluded to the aspiration of a dental prosthesis. After intubation and stabilization, the prosthesis could be manually extracted. However, the patient developed a Staphylococcus epidermidis sepsis and despite adequate antibiotic therapy, he eventually died. Dental prosthesis aspiration is a medical situation associated with a higher morbidity and mortality rate compared to ingested foreign bodies. It requires a high level of suspicion to ensure a timely diagnosis and life-saving treatment. Thorough history taking is of great importance in case of tracheobronchial aspiration, which is in the adult population mostly secondary to an underlying disorder. In impaired adults with missing dental prostheses there should be extra awareness for this problem. This case report illustrates the importance of a detailed history in case of tracheobronchial aspiration and shows the limitations in the diagnostic usefulness of bedside chest radiography.
我们报告一例66岁患有急性呼吸窘迫的白人男性病例。该患者有多次脑血管意外病史，导致左侧偏瘫、吞咽困难和失语。他被初步诊断为吸入性肺炎。然而，由于临床病情恶化，进一步检查发现是假牙吸入。插管并稳定病情后，可手动取出假牙。然而，患者发生了表皮葡萄球菌败血症，尽管进行了充分的抗生素治疗，他最终还是死亡了。与摄入异物相比，假牙吸入是一种发病率和死亡率较高的医疗情况。需要高度怀疑以确保及时诊断和挽救生命的治疗。在气管支气管吸入的情况下，全面的病史采集非常重要，在成年人群中，这大多继发于潜在疾病。对于假牙缺失的功能受损成年人，应格外警惕这个问题。本病例报告说明了气管支气管吸入情况下详细病史的重要性，并显示了床边胸部X线摄影在诊断方面的局限性。
