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Can A Chest Infection Occur From Inhaling Plastic Foreign Bodies?

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Posted on Thu, 26 Oct 2017
Question: Hi Doctor,
My 19 month old daughter has been picking off little pieces of plastic (like very thin sheets of plastic) off the baseboard of her bed. It end up EVERYWHERE and sometimes I find her in a lying with her head surrounded by these little plastic pieces in the morning. I am concerned she has breathed some of them in and they are in her lungs. 10 days ago she developed a fever with a cough. She has had a cough since and now she has had a fever for the last 3 nights with the cough. She often gets these terrible coughing fits that also cause her to vomit. She is not eating and is very lethargic and just wants to sleep. We took her to the emergency room last night and after an xray was performed, they confirmed she has a chest infection and sent us home with a script for antibiotics. My question is could this infection be caused by inhaling those small plastic foreign bodies? They stick to surfaces quite well so they could easily be stuck in her lungs. If so what could be done about this? I am so worried..
doctor
Answered by Dr. Sumanth Amperayani (19 minutes later)
Brief Answer:
This looks like a pneumonia rather than a foreign body in the lungs

Detailed Answer:
Hi...I understand your concern. But by what you quote this looks like a pneumonia than a foreign body in the lungs (as they have performed a chest X-ray and ruled out foreign body and they have started antibiotics, so I am assuming that it is pneumonia).

Coming to your question about the objects being inhaled and causing pneumonia, it is a possibility but for this to occur it will take a very long time.

But as you say the kid is coughing a lot, I have a few questions for you.

Questions:
1. How many days per month does she cough or feel breathless?
2. How many nights per month does her sleep get disturbed due to above symptoms?
3. Does she feel breathless when she runs around or plays with other kids?
4. Are the symptoms when there are seasonal changes?
5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
6. Is the cough always associated with fever?
7. Dis they take any blood test before starting antibiotics like CBC or blood culture?

CAN YOU UPLOAD THE IMAGE OF THE CHEST X-RAY TAKEN PLEASE. I WOULD LIKE TO HAVE A LOOK AT IT AND CONFIRM THE PNEUMONIA.


Please get back to me with answers so that I can guide you better.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Sumanth Amperayani (1 hour later)
HI Doctor, thanks for your reply. I asked the technician and they said the small plastic pieces would not show up on an Xray (they are white, paper thin, flexible and almost rubbery) when looking for a foreign body. I know you mentioned that it would take a long time to develop and coming to think of it, she has been chipping away at the headboard with her fingernails for a long time now (8 months or so) so there could have been many instances where she inhaled the plastic. I only noted this last episode because it was EVERYWHERE on her pillow. I do not have a copy of the images but I can certainly phone the hospital to ask that they send it to me. Below are the following answers to your questions

1) In the past 6 months or so she has had recurrent bouts of terrible coughs (sometimes sounding wet and she chokes and cries when she coughs,other times it sounds dry like a bark) but she seems to get coughs pretty frequently. Coming to think of it, I thought it was very strange that she would suddenly come down with these fevers and terrible coughs. They are always accompanied with a fever. They go away on their own but the next time she get a fever there is always a cough with it. In the past 7 months, she has probably had 6 episodes of coughing/fever.

2) When she does have these problems, she wakes up every night for around 3-5 nights crying and coughing.

3) She does not run around and get breathless when she is playing with other kids. She only coughs and breathes shallow when she has a fever.

4) I have not noticed any flare up with seasonal changes as she has had this problem across all the seasons-we live in Canada (she has had it in spring, summer, and fall)

5) No one in my family has asthma or skin allergies

6) The cough is almost always accompanied by a fever. Only one time did she have it without a fever to begin with

7) They did not do any blood work on her. Just a urine culture and the XRay. We have not started the antibiotics yet as we just got home from the emergency room a few hours ago

As I mentioned before, I am very worried that what could be causing these bouts of respiratory infections (pneumonia) is the little pieces of plastic. If it is, what is the remedy? diagnosis? etc. I am so very worried!
doctor
Answered by Dr. Sumanth Amperayani (2 hours later)
Brief Answer:
Looks like viral associated wheezing

Detailed Answer:
Hi....by what you say I feel that this is viral associated wheezing. I have a few suggestions for you.

Suggestions:
1. There are certainly alternative management therapies in allopathy now-a-days. Medicine has advanced a lot and this viral illness associated wheezing is 100% controllable.
2. Inhalers are the newest management strategies for this. If I were your paediatrician I would have suggested the use of Budecort metered dose inhaler (100mcg) 2 puffs twice a day through a spacer and this is for regular use for 8 weeks. Another metered dose inhaler is Levolin and this can used as rescue therapy whenever the kid is having severe cough in spite of regular usage of Budecort. The technique is very important and very crucial for the drug to be delivered correctly to the lungs. Regularity of medicine usage also matters a lot. So do not discontinue abruptly after you notice some improvement. The technique of administering an inhaler using a spacer has to be taught to you by your doctor and these are prescription medicines. So I suggest you consult your paediatrician for this.
3. Triggers can be environmental changes/ dust/ talcum powder/ seasonal changes/ un-cleaned a/c vents/ cold weather etc....we can specifically say this is the cause - unless we observe the kid closely - best person is the parent.

Coming to the other query raised by you -

I do not think that she has chronic foreign body aspiration as the lung changes would have been evident in x-ray even though the foreign bodies are not visible. So be rest assured about it.

PLEASE TRY TO UPLOAD THE X-RAY IMAGE.

Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.

Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Sumanth Amperayani (13 minutes later)
Hi Doctor, Can i upload the images to you tomorrow? I will try to get a copy of the xray today or tomorrow afternoon.
doctor
Answered by Dr. Sumanth Amperayani (1 minute later)
Brief Answer:
No problem - I will wait for your next reply with image

Detailed Answer:
Hi....no problem. I will wait for your next reply with image.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Sumanth Amperayani (38 hours later)
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Sumanth Amperayani (2 hours later)
Brief Answer:
The X-ray looks like not having any pneumonia - only increased markings

Detailed Answer:
Hi...The chest X-ray looks like not having any pneumonia. This shows just having increased bronchovascular markings. This means that the child is having only recurrent wheezing and not bacterial infection or pneumonia.

I suggest you go ahead with my suggestions on metered dose inhalers.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumanth Amperayani (5 hours later)
Ok thank you doctor. So can those little plastic pieces cause something like the bronchovascular markings? She is on the antibiotics and is improving. I am not sure why the doctor told me she had the beginnings of pneumonia though?

At this point she has no more fever, her cough is improving and not as bad. She is still a bit lethargic and not eating. I am very concerned about the plastic pieces. When I get home later I can send you a picture of the plastic pieces so you can see. Otherwise with pieces of debris that are small (but not tiny) would they typically stay in the lungs forever and cause infection or would the lungs handle it by expelling it?
doctor
Answered by Dr. Sumanth Amperayani (2 hours later)
Brief Answer:
Suggestions on x-ray findings

Detailed Answer:
Hi... I understand your concern. Please send the images of the plastic pieces. X-ray doesn't show the characteristic findings of foreign body aspiration into the lungs. Increased bronchovascular markings are signs of wheezing.

Coming to your query - lungs would not expel out the pieces if aspirated.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Sumanth Amperayani (2 days later)
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Sumanth Amperayani (4 hours later)
Brief Answer:
Suggestions on minute foreign body aspiration

Detailed Answer:
Hi... I have seen the images you have provided. The small pieces like this have a chance to get aspirated into the lungs and at the same time it is true that they will not be visible on X-Ray as they are radiolucent. But in the long run even though they are radiolucent, if at all they have been aspirated into the lungs there is a good chance that the changes caused by them can be picked up in the chest X Ray. If it is really required CT scan of the chest will definitely show the changes in the pulmonary parenchyma.

As of now there are no changes that are signifying this sort of changes in the lungs in the chest X Ray.

I suggest that you go ahead with the inhalers as I have recommended and we will follow up the case.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8346 Questions

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Can A Chest Infection Occur From Inhaling Plastic Foreign Bodies?

Brief Answer: This looks like a pneumonia rather than a foreign body in the lungs Detailed Answer: Hi...I understand your concern. But by what you quote this looks like a pneumonia than a foreign body in the lungs (as they have performed a chest X-ray and ruled out foreign body and they have started antibiotics, so I am assuming that it is pneumonia). Coming to your question about the objects being inhaled and causing pneumonia, it is a possibility but for this to occur it will take a very long time. But as you say the kid is coughing a lot, I have a few questions for you. Questions: 1. How many days per month does she cough or feel breathless? 2. How many nights per month does her sleep get disturbed due to above symptoms? 3. Does she feel breathless when she runs around or plays with other kids? 4. Are the symptoms when there are seasonal changes? 5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.? 6. Is the cough always associated with fever? 7. Dis they take any blood test before starting antibiotics like CBC or blood culture? CAN YOU UPLOAD THE IMAGE OF THE CHEST X-RAY TAKEN PLEASE. I WOULD LIKE TO HAVE A LOOK AT IT AND CONFIRM THE PNEUMONIA. Please get back to me with answers so that I can guide you better. Regards - Dr. Sumanth