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November 24, 1978

Migratory Pulmonary Infiltrates Secondary to Aspirated Foreign Body

Author Affiliations

From the Pulmonary Division, University of Arkansas for Medical Sciences, Little Rock.

JAMA. 1978;240(22):2469. doi:10.1001/jama.1978.03290220081027

IF AN aspirated foreign body is not expelled by cough, the patient may become totally asymptomatic, and a diagnosis may not be made until complications arise later.1 A chest roentgenogram usually shows a radiopaque foreign body; however, the diagnosis of a small or a radiolucent foreign body requires a high index of suspicion and careful bronchoscopy. Situations have been described in which the presence of a foreign body was not diagnosed until part of the lung was removed as treatment for abscess, bronchiectasis, or a suspected tumor.2

We describe an unusual presentation of an aspirated foreign body. Although the object was radiopaque, its presence on the initial chest roentgenograms was not detected.

Report of a Case  In May 1977, a 58-year-old mentally retarded man had a persistent cough, and a chest roentgenogram showed a right upper lobe infiltrate. He was treated with penicillin G procaine, and a repeated