Occult Sapodilla Seed Aspiration: Diagnostic Pitfalls and Retrieval Challenges

Bronchial foreign body aspiration (BFBA) in adults is uncommon and frequently overlooked, particularly in tuberculosis-endemic settings where it may mimic asthma or pulmonary tuberculosis, leading to prolonged diagnostic delay. We report a 55-year-old woman with a two-year history of treatment-refractory wheezing and progressive dyspnea, repeatedly misdiagnosed as asthma. Chest computed tomography revealed a smooth intraluminal lesion within the right basal trunk bronchus with surrounding post-obstructive inflammatory changes but no distal atelectasis. Flexible bronchoscopy identified and successfully removed an impacted sapodilla seed, resulting in immediate resolution of wheezing and complete radiologic recovery at follow-up. This case highlights the importance of meticulous clinical examination, recognition of atypical features of adult-onset wheezing, and early use of chest CT to identify endobronchial obstruction. Timely bronchoscopy remains the definitive diagnostic and therapeutic modality, preventing unnecessary prolonged treatment and irreversible pulmonary sequelae.