Hidden in plain sight: an unusual cause of chronic cough

A 71-year-old man, a former smoker, with a history of chronic productive cough, without an established diagnosis, consulted his primary care physician due to worsening of his usual cough pattern. Despite various studies and treatments, including inhaled bronchodilators and antibiotics, his condition progressively worsened. A chest computed tomography scan revealed a small atelectasis in the lingula, but lung function was normal. The pulmonologist advised him to accept his condition, as improvement seemed unlikely. However, due to the patient’s persistence, a bronchoscopy was performed, identifying the culprit: a chicken bone lodged in the intermediate neurologibronchus of the right lung. After its removal, the cough returned to its baseline pattern. This case underscores the importance of considering less common etiologies when addressing chronic cough. Ignoring these can lead to misdiagnosis, prolonged patient suffering, and unnecessary treatments.