title: Dental prosthesis aspiration: An uncommon cause of respiratory distress.
abstract: We present a case of a 66-year-old Caucasian man with acute respiratory distress. The patient had a history of multiple cerebrovascular accidents which resulted in left hemiplegia, swallowing problems, and aphasia. He was tentatively diagnosed with aspiration pneumonia. However, because of clinical deterioration further investigations concluded to the aspiration of a dental prosthesis. After intubation and stabilization, the prosthesis could be manually extracted. However, the patient developed a Staphylococcus epidermidis sepsis and despite adequate antibiotic therapy, he eventually died. Dental prosthesis aspiration is a medical situation associated with a higher morbidity and mortality rate compared to ingested foreign bodies. It requires a high level of suspicion to ensure a timely diagnosis and life-saving treatment. Thorough history taking is of great importance in case of tracheobronchial aspiration, which is in the adult population mostly secondary to an underlying disorder. In impaired adults with missing dental prostheses there should be extra awareness for this problem. This case report illustrates the importance of a detailed history in case of tracheobronchial aspiration and shows the limitations in the diagnostic usefulness of bedside chest radiography.
authors.affiliation: a Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium.
authors.forename: Belphine A L
authors.initials: BA
authors.lastname: De Wilde
authors.affiliation: b Department of Nephrology , Ghent University Hospital , Ghent , Belgium.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Malfait
authors.affiliation: c Department of Head and Neck Surgery , Ghent University Hospital , Ghent , Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Bonte
authors.affiliation: d Department of Respiratory Medicine , Ghent University Hospital , Ghent , Belgium.
authors.forename: Thomas L A
authors.initials: TL
authors.lastname: Malfait
mesh_terms: D000368:Aged; D001980:Bronchi / Q000000981:diagnostic imaging / Q000293:injuries*; D001999:Bronchoscopy; D017266:Dental Prosthesis; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology*; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male
keywords: Dental prosthesis; Foreign body aspiration; Staphylococcus epidermidis sepsis