Saudi Journal of Medicine and Medical Sciences

LETTER TO THE EDITOR
Year
: 2016  |  Volume : 4  |  Issue : 3  |  Page : 240--241

Chronic foreign body aspiration in a Saudi child - an occult cause of chronic pulmonary disease: Case report and literature review


Mahmood Dhahir Al-Mendalawi 
 Department of Paediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
P.O. Box 55302, Baghdad Post Office, Baghdad
Iraq




How to cite this article:
Al-Mendalawi MD. Chronic foreign body aspiration in a Saudi child - an occult cause of chronic pulmonary disease: Case report and literature review.Saudi J Med Med Sci 2016;4:240-241


How to cite this URL:
Al-Mendalawi MD. Chronic foreign body aspiration in a Saudi child - an occult cause of chronic pulmonary disease: Case report and literature review. Saudi J Med Med Sci [serial online] 2016 [cited 2021 Apr 17 ];4:240-241
Available from: https://www.sjmms.net/text.asp?2016/4/3/240/188268


Full Text

Sir,

I have two comments on the interesting case report by Al-Zahrani.[1]

First, the author did well in confirming the diagnosis of foreign body (FB) aspiration by bronchoscopy after excluding immunological and chronic lung diseases in their studied patient.[1] However, the author did not consider an important sequelae of long-term aspirated FB, 11-month duration in the case in question. It is obvious that pulmonary aspergillosis is a mycotic disease usually caused by Aspergillus fumigatus, a saprophytic and ubiquitous airborne fungus. Its occurrence depends on the immunologic status of the host and the existence of an underlying lung disease. Aspergilloma usually results from the ingrowths of colonized Aspergillus in the damaged bronchial tree, pulmonary cavities, or cysts of patients with underlying pulmonary diseases.[2] Aspergilloma-associated FB has been recently reported.[3] Although the FB was successfully removed in the case in question, histopathologic examination of the biopsy specimen was solicited. If that was contemplated and revealed fungal hyphae characteristic of Aspergillus species, it would be a novel case report in the Kingdom of Saudi Arabia (KSA) as pediatric aspergilloma-associated FB is rarely reported in literature.[3]

Second, although no recent studies are available on the exact magnitude of childhood FB aspiration in the KSA, the available data indicate that it occurs at a high frequency. A retrospective study on Saudi pediatric patients who had bronchoscopy for suspected FB in the tracheobronchial tree revealed a FB in 64% of cases.[4] I, presume that certain strategic preventive guidelines ought to be implemented to limit further rise in its magnitude. The American Academy of Pediatrics has issued guidelines on the prevention of choking in children, which could be implemented in the KSA. They include the education of parents, teachers, child care workers, and other child caregivers to supervise and create safer environments for children; enactment and enforcement of safety legislation that will lead to surveillance and reduction of the availability of hazardous products in the market; and product design changes that will reduce the inherent choking risk of consumer products, especially toys.[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Al-Zahrani MS. Chronic foreign body aspiration in a Saudi Child – An occult cause of chronic pulmonary disease: Case report and literature review. Saudi J Med Med Sci 2015;3:238-40.
2Chabi ML, Goracci A, Roche N, Paugam A, Lupo A, Revel MP. Pulmonary aspergillosis. Diagn Interv Imaging 2015;96:435-42.
3Mitchell CA, Kreiger P, Goff C, Shah UK. Pediatric foreign body aspiration: A nidus for Aspergillus colonization. Int J Pediatr Otorhinolaryngol 2015;79:938-40.
4Siddiqui MA, Banjar AH, Al-Najjar SM, Al-Fattani MM, Aly MF. Frequency of tracheobronchial foreign bodies in children and adolescents. Saudi Med J 2000;21:368-71.
5Committee on Injury, Violence, and Poison Prevention. Prevention of choking among children. Pediatrics 2010;125:601-7.