Unexpected spontaneous expectoration of a grass bur: A case report

• Published in: SAGE open medical case reports Vol. 12; p. 2050313X241274970
• Main Authors: Alaniz, Jacob A., Armstrong, Peyton, Bosley, Alexander, Mavratsas, Vasilis, Reinertson, Randal
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2024; Sage Publications Ltd; SAGE Publishing
• Subjects: empyema; pleuritic chest pain; grass bur; chest tube; Foreign body; aspiration
• ISSN: 2050-313X; 2050-313X
• DOI: 10.1177/2050313X241274970

Adult foreign body aspiration is rare and represents only 15%–25% of all foreign body aspirations and 1 in 400 bronchoscopy procedures. Typically, adults present non-emergently and exhibit non-specific symptoms, which makes the diagnosis of foreign body aspiration especially difficult when a history of aspiration cannot be elicited. We present a 63-year-old male with a past medical history of chronic obstructive pulmonary disease hospitalized for left thoracic empyema caused by the aspiration of a grass bur. Our patient did not recall the aspiration event and the diagnosis was further obfuscated by a lack of radiographic evidence and other distracting disease processes. Thus, this case exemplifies the rationale for maintaining a suspicion of foreign body aspiration even for patients with little historical or radiographic evidence to support the presence of a foreign body. This is particularly salient for patients with a tumultuous hospital course or those who fail to respond to treatment.