A 4-year-old girl was presented with intermittent fever and non-productive cough of 1-month duration. The mother mentioned of seeds' choking incident that occurred 3 weeks before the onset of symptoms. She had no other symptoms. Family history was significant for leukemia. Physical Examination The patient was active and did not look in any physical distress. Chest radiograph (1st image) showed a complete collapse of the left lung.
Laboratory investigations indicated: WBC: 23000/mm 3 (73% of polymorphonuclear cells and 17% lymphocytes) Hemoglobin 10 g/dL, hematocrit 30.5%, and platelets 543,000/mm 3 . CRP was 8.5mg/dL (negative < 0.3). The purified protein derivative (PPD) test was negative. Rigid bronchoscopy revealed a small part of seed was surrounded by a grayish-white polypoid mass adherent to the bronchial wall and was obstructing the orifice of the left main stem bronchus. Removal…
