Long-standing aspirated foreign body in a child complicated by pneumothorax and empyema

Abstract

Foreign-body aspiration is a common paediatric emergency requiring immediate recognition and management. We report a case of a four-yearold boy who presented to the Emergency Department at Al Sabah Children’s Hospital in Juba, South Sudan, with a two-month history of an inhaled foreign body (bead). He had previously attended several healthcare facilities with recurrent chest infections that led to acute respiratory distress. On admission, he was managed for respiratory failure, severe aspiration pneumonia, pleural empyema/lung abscess, and pneumothorax. Despite the prolonged aspiration and a prior unsuccessful bronchoscopic retrieval attempt, the foreign body was expelled after back blows. The child developed complications necessitating chest tube thoracostomy, prolonged intravenous antimicrobial therapy, oxygen supplementation, and anti-tuberculosis treatment. His clinical condition gradually improved. Prevention of foreign-body aspiration in children requires restricting access to high-risk choking objects and providing age-appropriate feeds.