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BMJ Case Rep. 2010; 2010: bcr08.2009.2203.
Published online 2010 January 13. doi:  10.1136/bcr.08.2009.2203
PMCID: PMC3027945
Reminder of important clinical lesson

Pulmonary protection


This report describes the case of a 23-year-old woman who presented with symptoms, signs and radiology suggesting pneumonia. Despite courses of antibiotics, her condition did not improve. Bronchoscopy was eventually performed which revealed a membranous object in her right upper lobe bronchus. The object was easily removed and discovered to be a condom. Retrospective questioning found that the women was currently working as an escort girl and often performed oral sex on male clients. The patient remembered coughing very violently during a recent session which is presumably when the condom was inhaled. She had not volunteered this information initially as she was sensitive about her occupation, and also because she had not been directly asked. This case illustrates the importance of taking a detailed occupational history from a patient presenting with respiratory symptoms as this may have led to a quicker diagnosis and spared the patient courses of antibiotics.

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