Foreign body aspiration imitating a difficult-to-treat asthma

Abstract

Tracheobronchial foreign body (FB) aspiration is an infrequent but possibly fatal event in adults. Symptoms typically consist of a choking incident followed by cough and dyspnea; however, these findings are conflicting, and symptoms may mimic other chronic pulmonary diseases such as asthma or chronic obstructive pulmonary disease. Chest radiography and computed tomography can offer information with regard to the site and features of the FB and support the diagnosis. Bronchoscopy remains the gold standard for diagnosis and management of FB aspiration. A 38-year-old woman with persistent cough of 4 months’ duration, received several lines of treatment for bronchial asthma. She presented with refractory cough and chest tightness, and high-resolution computed tomography chest showed a small calcified lesion in the bronchus intermedius. Fiberoptic bronchoscopy revealed a chicken bone in the bronchus intermedius which was removed, followed by a complete recovery of symptoms and discontinuation of all asthma treatment.