Cause of Chronic Cough
A 31-year-old man sought medical help for suspected foreign-body aspiration. He had been suffering from recurrent pulmonary infections with intense coughing for six months. Repeated courses of antibiotics had failed to bring about permanent improvement, and computed tomography of the chest showed partial atelectasis of the right lower lobe distal to a foreign body.
Bronchoscopy revealed the aspirated object in the right lower lobe bronchus, with massive surrounding mucosal irritation. The object was successfully removed with a Dormia basket and identified as a tooth. The patient reported having undergone a difficult wisdom tooth extraction in which the tooth could not be removed in one piece and a fragment of the extracted tooth was noted to be missing. It had been assumed that the patient had swallowed it.
Foreign-body aspiration can cause recurrent pulmonary infection. Even in young patients, aspiration should be considered in the differential diagnosis. Patients with chronic cough (>8 weeks) should be evaluated with a chest x-ray and a pulmonary function test. The same is recommended for patients with community-acquired pneumonia that takes a complicated course.
Dr. med. Gero Schulze, Prof. Dr. med. Hans-Jürgen Seyfarth, Universitätsklinikum Leipzig AöR, Department für Innere Medizin, Neurologie und Dermatologie,
Abteilung für Pneumologie, Gero.Schulze@medizin.uni-leipzig.de
Conflict of interest statement: The authors state that they have no conflict of interest.
Translated from the original German by Ethan Taub, M.D.
Cite this as: Schulze G, Seyfarth H-J: A rare cause of chronic cough. Dtsch Arztebl Int 2018; 115: 11. DOI: 10.3238/arztebl.2018.0011a