Unravelling the Impact of Foreign Bodies on Bronchiectasis: Insights From a Case Series Study

Foreign body (FB) aspiration in adults is a rare yet critical event that can mimic chronic respiratory conditions such as asthma or bronchitis, often causing delays in diagnosis and treatment. This case series explores the presentations of four adult patients, each with a prolonged history of chronic cough, who were later discovered to have aspirated foreign bodies. Initial misdiagnoses and the limitations of high-resolution CT scans in detecting these foreign bodies contributed to delays in reaching an accurate diagnosis. Interestingly, three of the cases involved aspirated vegetative matter, which went undetected on imaging and was only identified through bronchoscopy. The fourth patient, a young adult male, had aspirated a safety pin, which led to empyema, a severe complication highlighting the risks associated with delayed diagnosis. A key finding in this series is the significant role of flexible bronchoscopy in both diagnosing and managing FB aspiration. In each case, flexible bronchoscopy, guided through a rigid bronchoscope, was instrumental in successfully removing the foreign bodies, even in complex cases involving vegetative material or sharp objects. This case series underscores the importance of considering FB aspiration in adults with unexplained chronic cough, especially when conventional imaging does not reveal a clear cause. The diagnosis of airway foreign body requires a thorough clinical history and assessment of risk factors, with bronchoscopy serving as a crucial diagnostic and therapeutic tool when CT scans are inconclusive and stressing the need for timely diagnosis and intervention to prevent severe complications and improve patient outcomes.