Diagnosis of a missed bronchial foreign body in an 8-year-old girl: a rare case report

Tracheobronchial foreign body aspiration (TB-FBA) with subsequent airway obstruction typically occurs in children younger than 4 years. TB-FBA results in significant morbidity and mortality in children requiring urgent recognition and prompt management. Some cases remain more indolent and cause unusual respiratory insults ranging from chronic respiratory symptoms such as persistent cough, wheezing, and recurrent pneumonia to life-threatening airway obstruction. This case report presents a rare case of TB-FBA in an 8-year-old girl with a prolonged history of cough and dyspnea for 15 months despite many medical treatments and a rigid bronchoscopy examination performed by a board-certified pediatric surgeon. The patient was referred to Namazi Hospital's Pediatric Interventional Pulmonology Division where fiberoptic bronchoscopic exploration was conducted to remove a foreign body (a 6-cm wheat cluster) from the right lower lobe bronchus. This case report demonstrates the importance of clinical history in the diagnosis of aspirated foreign bodies despite unusual age and normal radiological findings.