An 11-year-old male presented with hemoptysis.
Among the personal history, the most important was the emission of blood by the mouth 3 years before an undetermined origin, and no radiological study was performed.
She had no history of recurrent respiratory infections, chest trauma, kidney disease, or anemia.
No foreign body aspiration was reported.
Three weeks prior, the patient had presented with fever that resolved with antibiotic treatment, and cough persisted, accompanied by hemoptoic sputum in the last week.
She was admitted to the emergency department of this hospital with hemoptysis of 150 cc, without hemodynamic compromise, and without other accompanying symptoms.
On examination, the patient presented TA: 110/70 mmHg, HR: 90 bpm, Ta: 36 oC, RR: 12 bpm, with good coloration of the skin and mucous membranes.
The oropharynx was normal.
IY, goiter, no lymphadenopathy.
Peripheral pulses were symmetrical.
Cardiac auscultation was normal.
Pulmonary auscultation revealed left basal hypophonesis.
The abdomen, neurological examination and extremities were normal.
Complete blood count, biochemistry, urine tests, coagulation, rheumatoid factor, complement, immunoglobulins, proteinogram, ANA and baseline anti-anxiety antibody were normal.
Mantoux test was negative.
The CGE did not present pathological findings.
Usual flora was isolated from sputum microbiology.
A chest X-ray showed an interstitial alveolar infiltrate in the left lower lobe.
Chest CT showed condensation in the posterior basal and lateral segments of the LII, with air bronchogram.
In the respiratory functional study, only a moderate decrease in diffusion (D/VA: 65%) was observed.
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Bronchoscopy showed a mucosa with inflammatory signs in the left main bronchus, especially in the basal pyramid, with whitish mucous secretion at S9 level.
In the microbiological examination of bronchial aspirate, Eikenella Corrodens was isolated, and the cytological study showed malformations.
Because of the bronchoscopic findings, the hemoptysis control therapy was associated with antibiotic treatment (amoxicillin-Clavula) and CT was repeated three weeks later, the radiological infiltrate persisted.
The patient, who had continued with a dry cough, predominantly nocturnal, was admitted again one month later for hemoptysis of 250 cc. without hemodynamic repercussions.
An echocardiogram showed no abnormalities.
Bronchoscopy was repeated for the same alterations seen previously.
Bronchoalveolar lavage was performed in S9.
After several asymptomatic days, the patient was referred to his home waiting for outstanding results.
Two to three days after discharge, the patient presented intense cough eliminating a foreign body of organic origin, specifically an ear.
The unawareness of family members about inhalation, remembered that 3 years earlier he sighed herbs while playing in the field.
