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What wheezes is not always bronchial asthma
Authors Information

Department of Pneumonology,
Army General Hospital of Athens,
Athens, Greece

Keywords: Wheezing, Aspiration
Full text

A 64 years-old female came to the out-patient clinic because of chronic cough and wheezing. As she could recall, the cough had begun suddenly during a meal, about a month ago. She had a history of bronchial asthma that was well-controlled until then by inhaled long acting bronchodilators, inhaled corticosteroids and montelukast. She and her doctor thought that it was again another asthma exacerbation, but this time her symptoms persisted despite her adherence to the usual treatment scheme plus a short course of oral corticosteroids.

Auscultation of the chest revealed wheezing localized at the left hemithorax, which raised the suspicion of aspiration. Fiberoptic bronchoscopy was performed then. Panels A and B show the bronchoscopic image of the left main bronchus before and after the removal of the aspirated foreign body respectively, which was a piece of lamb bone (panel C). Biopsies of the inflammatory tissue at the site of the impaction of the bone revealed chronic inflammation with squamous metaplasia, which gradually subsided as it was shown by subsequent bronchoscopies and biopsies of the area three and six months later.

Conflicts of interest