Pradhan Monalisa, Gohil Krutika M, Shinde Srinivasrao G, Khan Zoha, Nadeem Arsalan, Wanjari Mayur, Mittal Gaurav
Department of Paediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Medicine, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. Rustom Narsi Cooper Municipal General Hospital, Mumbai, Maharashtra, India.
J Family Med Prim Care. 2025 Feb;14(2):800-803. doi: 10.4103/jfmpc.jfmpc_515_24. Epub 2025 Feb 21.
Foreign body aspiration in pediatric patients presents a significant challenge in diagnosis and management, often leading to acute respiratory distress. We report the case of a 4-and-a-half-year-old male child with a history of recurrent left-sided lobar pneumonia, who presented with high-grade fever and cough persisting for 14 days. Despite lacking distress or stridor, a routine chest X-ray revealed right-sided lower lobe pneumonia, prompting further investigation. Auscultation revealed reduced air entry and crepitations in the right lower lobe. Bronchoscopy confirmed the presence of a deep-seated foreign body (a wheel of a toy car with its axle) in the right main bronchus. Prompt intervention by an ENT surgeon led to the successful removal of the foreign body under general anesthesia. Post-procedural care included intravenous administration of dexamethasone and ceftriaxone, along with budecort nebulization. This case highlights the complexities in diagnosing foreign body aspiration and emphasizes the importance of prompt intervention to prevent complications and ensure favorable outcomes.
小儿患者的异物吸入在诊断和治疗方面面临重大挑战,常导致急性呼吸窘迫。我们报告一例4岁半男童,有复发性左侧大叶性肺炎病史,此次因高热和咳嗽持续14天就诊。尽管没有呼吸困难或喘鸣,但常规胸部X线检查显示右下叶肺炎,遂进行进一步检查。听诊发现右下叶呼吸音减弱并伴有湿啰音。支气管镜检查证实右主支气管内有一个深部异物(玩具汽车带轴的轮子)。耳鼻喉科医生迅速进行干预,在全身麻醉下成功取出异物。术后护理包括静脉注射地塞米松和头孢曲松,以及布地奈德雾化吸入。该病例突出了异物吸入诊断的复杂性,并强调了及时干预以预防并发症和确保良好预后的重要性。