title: Diagnose of occult bronchial foreign body: A rare case report of undetected Chinese medicine aspiration for 10 long years.
abstract: BACKGROUND
  Occult bronchial foreign body can be very difficult to diagnose early in an adult patient without acute symptoms. This report describes a rare case of undetected Chinese medicine "Coptis chinensis" aspiration for 10 long years.
  
  
  METHODS
  A case was reported that a female patient complained of a 10-year history of productive cough. A battery of tests were given to confirm the diagnosis.
  
  
  RESULTS
  Chest computed tomography (CT) showed extensive bronchiectasis and multiple nodules, along with stenosis of left lower lobar bronchus. An extensive solid lesion with surrounding inflammatory granulation tissue was seen on her first bronchoscopy and biopsy revealed chronic mucosal inflammation. A neglected history of Coptis chinensis regularly kept in-mouth while sleeping for the last 10 years in this patient provided clues for a final diagnosis. Confirmatory diagnosis of bilateral tracheobronchial foreign bodies caused by recurrent inhalation of Coptis chinensis was made by a second bronchoscopy.
  
  
  CONCLUSIONS
  This case clearly demonstrates that a precise medical history is often overlooked. A high index of suspicion, a precise medical history, radiographic features of chronic respiratory symptoms not explained by other conditions were keys to diagnosing this case.
authors: Department of Pulmonary Medicine, The first affiliated of Zhejiang University School of medicine, Hangzhou, China Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital,Tongji University School of Medicine, Shanghai.
authors: Lan
authors: L
authors: Wang
authors: Bigyan
authors: B
authors: Pudasaini
authors: Xue-Fen
authors: XF
authors: Wang
mesh_terms: D000328:Adult; D001999:Bronchoscopy / Q000379:methods; D057210:Delayed Diagnosis; D004365:Drugs, Chinese Herbal / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000175:diagnosis* / Q000601:surgery; D015745:Granuloma, Foreign-Body / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D001239:Inhalation; D013902:Radiography, Thoracic / Q000379:methods; D035583:Rare Diseases; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D004365:Drugs, Chinese Herbal