A migrating intrathoracic leaf complicated by empyema in a child

Management of aspirated foreign body in children is challenging. In situations when the incidence is not witnessed, the diagnosis is delayed which results in later complications. When neglected, the diagnosis becomes eluding as the presentation mimics other chest pathologies. Overlooked foreign bodies result in serious complications such as lung abscess and pyothorax. Migration of aspirated foreign bodies is reported. Empyema complicating a neglected foreign body was reported once in adults but not in pediatric population. We present a case of a child with pyothorax. Intraoperatively, an intrathoracic leaf was found to be the cause.