An unusual presentation of necrotizing pneumonia caused by foreign body retention in a 20-month-old child: A case report and literature review

Abstract

Necrotizing pneumonia (NP) is a rare but serious complication that occurs after foreign body retention. We report a case of severe NP in an infant caused by foreign body retention in the airway with no choking history. After a timely tracheoscopy and effective antibiotic treatment, her initial clinical symptoms were alleviated. However, she subsequently exhibited pulmonary manifestations of necrotizing pneumonia. To reduce the risk of NP from foreign body aspiration, for patients with airway obstruction and asymmetrical opacity of both lungs, timely diagnostic bronchoscopic evaluation is essential.

Keywords: bronchiectasis; children; foreign body aspiration; necrotizing pneumonia; visit time.

Figure 1

Chest plane computed tomography at 5 days before admission (A–D) showing left lung consolidation (lung window) and (E–H) consolidation of the left lung with a small amount of pleural effusion (mediastinal window).

Figure 2

Chest x-ray on the day of admission showing atelectasis of the left lung (A). Flexible bronchoscopy showing a nut-like foreign body (B). A nut shell - like foreign object after removal (C). Review flexible bronchoscopy for foreign body retention (D).

Figure 3

Chest computed tomography on the seventh day of admission showing left lung consolidation, atelectasis (A–E), and CT scan and airway reconstruction (F) multiple saccular changes in the left lung, indicating necrotizing pneumonia.

Figure 4

Chest computed tomography at 10 weeks of onset showed that bronchiectasis of the left lung was still present and the consolidation of left lung lesions was improved. A-B (lung window), C-D (mediastinal window).