Alive in the Airways: Live Endobronchial Foreign Bodies

Unusual Presentation of Pleural Space Ascariasis Infection from Eastern Sudan: A Case Report

Background

Ascaris lumbricoides is a common infectious parasite of the gastrointestinal tract worldwide, but the invasion of the pleural cavity is rare.

Case Report

A 45-year-old man from Eastern Sudan presented to the emergency department complaining of breathlessness, cough stained with blood, and chest pain one month before his presentation. Also, he complained of high-grade fever for two weeks associated with sweating. Diagnosis of hydropneumothorax was made and a chest tube was inserted, two days later we found three adult A. lumbricoides worms in the chest drain.

Conclusion

The patient was treated with Albendazole 200 mg, orally twice, daily for seven days, he improved and was referred to a cardiothoracic surgeon for more assessment. Our study highlights that internal medicine specialists should know about pleural ascariasis when patients present with respiratory signs and symptoms, especially in A. lumbricoides endemic regions like Eastern Sudan.

Capsule endoscopy in airway: a difficult extraction

Foreign bodies of different nature are identified in airway. Extraction of foreign bodies given their dimension and character requires proper set of instruments with right technique to ensure safe removal. Different tools have been discussed to optimally withdraw the object in various articles which have been applied. However, we talk about a case of removal of a pill camera from an elderly patient’s right main bronchus with a certain positioning of the patient after multiple unsuccessful attempts with instruments alone. In conclusion, pill camera as being useful for surveillance for gastrointestinal pathology can have the potential of aspiration.

Regional dietary characteristics and bronchial foreign body: a repeated misdiagnosis caused by a red pepper

Bronchial foreign body is a common health problem worldwide, types of bronchial foreign bodies are variegated, depending on patient age and cultural background including religious beliefs as well as alimentary habits. However, misdiagnoses caused by regional dietary correlation factors were rarely concerned. In this case, a 52-year-old woman with aggravated cough and hemosputum took thoracic CT scan twice and flexible fiberoptic bronchoscopy 5 times, which all revealed the chronic pulmonary inflammation. Furthermore, the biopsies showed bronchial granulation nodule formation. With the highly suspicion of tumor, lung lobe resection was conducted. However, from the resected specimen, we belatedly found a red pepper inserted in the bronchus, without tumor cell in postoperative pathological analysis. We reviewed the case, analyzed the potential factors that may led to repeated misdiagnoses, and concluded that regional dietary characteristics and higher clinical suspicion should be seriously under consideration in the process of diagnosis.