From common to critical: intervention in complicated fishbone with atypical infection.

Abstract

A 90-year-old female patient presented with odynophagia and dysphagia after ingestion of fish (Cod). A foreign body impacted in the hypopharynx with supraglottic edema was diagnosed. Endoscopy and surgical extraction were performed, complicated by infection; cultures of purulent secretion yielded Acinetobacter junii and Pseudomonas aeruginosa, both sensitive to ciprofloxacin at antipseudomonal doses. Gastrointestinal foreign bodies (GFB), especially fish bones, are a common cause of clinical consultation and may lead to severe complications if not adequately managed. Most GFBs pass through the digestive tract without sequelae, but a significant proportion requires endoscopic or surgical intervention. Clinical evaluation should be complemented by imaging studies for accurate identification and management. Endoscopy allows precise diagnosis and therapeutic extraction but is contraindicated in cases of perforation. This case highlights the importance of early management of foreign bodies in geriatric patients to prevent serious complications such as mediastinitis and cardiac tamponade, as well as the significance of appropriate antibiotic treatment against uncommon infections in high-risk patients.