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Symptoms Of Prolonged Foreign Body Sojourn In The Bronchus





Category: FOREIGN BODIES IN THE AIR AND FOOD PASSAGES
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

1. The time of inhalation of a foreign body may be unknown or
forgotten.
2. Cough and purulent expectoration ultimately result, although
there may be a delusive protracted symptomless interval.
[130] 3. Periodic attacks of fever, with chills and sweats, and
followed by increased coughing and the expulsion of a large amount of
purulent, usually more or less foul material, are so nearly diagnostic
of foreign body as to call for exclusion of this probability with the
utmost care.
4. Emaciation, clubbing of the fingers and toes, night sweats,
hemoptysis, in fact all of the symptoms of tuberculosis are in most
cases simulated with exactitude, even to the gain in weight by an
out-door regime.
5. Tubercle bacilli have never been found, in the cases at the
Bronchoscopic Clinic, associated with foreign body in the bronchus.*
In cases of prolonged sojourn this has been the only element lacking
in a complete clinical picture of advanced tuberculosis. One point of
difference was the almost invariably rapid recovery after removal of
the foreign body. The statement in all of the text-books, that foreign
body is followed by phthisis pulmonalis is a relic of the days when
the bacillary origin of true tuberculosis was unknown, hence the
foreign-body phthisis pulmonalis, or pseudo tuberculosis, was confused
with the true pulmonary tuberculosis of bacillary origin.
6. The subjective sensation of pain may allow the patient accurately
to localize a foreign body.
7. Foreign bodies of metallic or organic nature may cause their
peculiar taste in the sputum.
8. Offensive odored sputum should always suggest bronchial foreign
body; but absence of sputum, odorous or not, should not exclude
foreign body.
9. Sudden complete obstruction of one main bronchus does not cause
noticeable dyspnea provided its fellow is functionating.
[131] 10. Complete obstruction of a bronchus is followed by rapid
onset of
symptoms.
11. The physical signs usually show limitation of expansion on the
affected side, impairment of percussion, and lessened trans-mission or
absence of breath-sounds distal to the foreign body.

* The exceptional case has at last been encountered. A boy with a tack
in the bronchus was found to have pulmonary tuberculosis.





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