A case of unreported foreign body aspiration mimicking asthma in an adult
Unreported or unnoticed foreign body aspirations are rare in adults but not children. However, this prejudice may lead to a misdiagnosis or delayed diagnosis. We report the case of a 50-year-old woman who choked while eating bread rolls containing walnuts and figs; however, she did not notice that she had aspirated anything. Subsequently, she experienced a persistent cough and gradually complained of dyspnea and wheezing. Because of the prominent wheezing in her chest, a physician at a nearby clinic diagnosed an asthma attack and prescribed asthma drugs, including inhaled corticosteroids. However, her symptoms did not improve. The physician doubted the diagnosis of asthma and performed chest computed tomography, which revealed a foreign body in the right truncus intermedius. We then performed a bronchoscopy and confirmed a brown substance embedded in the right lower lobe bronchus, which was picked up using a basket. It was a walnut made from bread. The patient’s symptoms immediately improved after removal. Even if an adult patient does not notice or report foreign body aspiration, physicians should consider this for differential diagnosis.
