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Symptoms Of Prolonged Foreign Body Sojourn In The Bronchus

Sources: A Manual Of Peroral Endoscopy And Laryngeal Surgery

1. The time of inhalation of a foreign body may be unknown or


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 for
ign 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


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.