Forgotten Foreign Body Aspiration Presenting as Allergic Bronchopulmonary Aspergillosis: A Case Report

TL;DR

A man with a long history of blood-stained sputum was found to have a forgotten plastic pen cap in his lung, initially mistaken for a fungal infection.

Contribution

Highlights the diagnostic challenge of forgotten foreign body aspiration mimicking allergic bronchopulmonary aspergillosis.

Findings

A 40-year-old male had a plastic pen cap in his lung for 20 years without immediate symptoms.

The foreign body was initially misdiagnosed as allergic bronchopulmonary aspergillosis.

Video bronchoscopy confirmed the presence and retrieved the foreign body.

Abstract

The usual presentation of foreign body (FB) aspiration into the tracheobronchial tree is a choking sensation followed by recurrent respiratory symptoms. Without a definitive history, the diagnosis of FB aspiration can be challenging. Here, we present a case of a 40-year-old male who presented with recurrent episodes of blood-stained sputum over the past six years. Contrast-enhanced computed tomography of the chest and serological investigations suggested allergic bronchopulmonary aspergillosis. Video bronchoscopy was performed for the hemoptysis workup, which identified and retrieved a plastic pen cap from the right lower lobe bronchus. On questioning, the patient disclosed a history of FB aspiration 20 years ago. Because he did not develop any immediate symptoms, he assumed that he probably swallowed the FB and never divulged it.

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