title: Complicated and dislodged airway foreign body in an intubated child: case report.
abstract: OBJECTIVE
  We report a case of missed foreign body aspiration in a child presenting with status epilepticus. On admission, the patient was found to have pneumonia, which progressed to respiratory failure and acute respiratory distress syndrome. While the patient was intubated and mechanically ventilated, the patient experienced acute respiratory deterioration. Subsequently, it was determined that a previously undetected foreign body had dislodged from the right main to the left main bronchus and was the underlying cause for the child's illness.
  
  
  CONCLUSIONS
  A combination of sudden change of physical and radiographic findings with unilateral lung hyperinflation is highly suspicious for an obstructing airway foreign body. This case demonstrates that foreign body aspiration can lead to significant morbidity. It should be in the differential diagnosis for any acute pulmonary process in an otherwise well child because there is no specific clinical or radiographic finding to rule it out.
authors.affiliation: Children's Hospital at Downstate, SUNY Downstate College of Medicine, Division of Pediatric Pulmonology, Brooklyn, NY, USA. kgraw-panzer@downstate.edu
authors.forename: Katharina D
authors.initials: KD
authors.lastname: Graw-Panzer
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Wadowski
authors.forename: Haesoon
authors.initials: H
authors.lastname: Lee
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004569:Electroencephalography; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D013902:Radiography, Thoracic; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D013226:Status Epilepticus; D014057:Tomography, X-Ray Computed