Pneumonia with a twist: Intravascular Foreign Body – Case Report

ABSTRACT
Intravascular foreign bodies (IFBs) are a rare but potentially serious condition in pediatrics, often iatrogenic due to central venous catheterization. We present the case of a girl with history of congenital cytomegalovirus (CMV) infection, who underwent central venous access placement in early infancy. Following the years, during investigations for a respiratory infection, an incidental finding of a hyperdense formation about 15 mm in size was noted at the bifurcation of the right interlobar artery, interpreted as an intraluminal foreign body, likely endothelialized. In the absence of clinical or laboratory signs of infectious or thromboembolic complications, surgical or percutaneous intervention was ruled out, and a clinical-radiological surveillance strategy was adopted. A review of the literature highlights the
need for a personalized therapeutic approach, with preference for percutaneous removal in symptomatic patients or when complications are presumable. However, in the presence of stable, endothelialized, and clinically silent foreign bodies, a conservative approach is feasible. This case emphasizes the importance of follow-up in patients with a history of central venous access and contributes to defining criteria for individualized management.