OVERLOOKED FOREIGN BODY ASPIRATION IN AN ADOLESCENT WITH AUTISM SPECTRUM DISORDER
DOI:
https://doi.org/10.46793/PP260131025FKeywords:
foreign body aspiration, bronchoscopy, autism spectrum disorder, adolescents, persistent coughAbstract
Introduction: Foreign body aspiration is an emergency and potentially life threatening condition, most commonly observed in children under the age of three. In older children and adolescents, it occurs less frequently and is often overlooked due to nonspecific clinical manifestations and the absence of reliable anamnestic information. Individuals with autism spectrum disorder and other neurodevelopmental conditions are at particularly increased risk, as behavioral characteristics and impaired communication constitute significant factors both for aspiration and for delayed recognition and diagnosis.
Case Report: We present the case of a fifteen year old adolescent with autism spectrum disorder who was hospitalized for persistent cough and fever lasting one month, unresponsive to prior antibiotic therapy. Difficulties in obtaining a reliable medical history and the absence of witnesses to the aspiration event contributed to a delayed diagnosis. Upon admission chest radiography demonstrated atelectasis and consolidation of the basal segments of the right lung. Flexible bronchoscopy revealed complete obstruction of the right intermediate bronchus by a foreign body (a figurine from a board game), which was successfully extracted using rigid bronchoscopy. Following removal of the foreign body, the patient experienced rapid clinical improvement and complete radiological resolution of pathological findings.
Conclusion: Foreign body aspiration should be considered in older children and adolescents with autism spectrum disorder who present with prolonged, nonspecific respiratory symptoms. In the presence of a high index of clinical suspicion, bronchoscopy serves as an indispensable diagnostic and therapeutic modality and should be performed in order to prevent serious respiratory complications.
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