Tuberculosis (TB) is a painful disease affecting the lungs, which today still kills over a million people per year worldwide. It's estimated that around a quarter of the Earth's population is infected with TB bacteria, though they haven't become ill with the disease. Of these, the World Health Organization writes, around 5-10 percent have a chance of falling ill with the disease, particularly if their immune system is weakened.
Left untreated, 45 percent of people ill with TB will die, and nearly all of those who are also HIV positive upon falling ill. Though it may be seen as a disease of the past, it's still very much around today and requires lengthy courses of antibiotics as a treatment.
But sometimes, it's a condom.
A 27-year-old woman showed up to hospital with a cough, fever, and thick mucus that had been persistent for six months. Four months prior to attending hospital, she had been prescribed antibiotics and anti-tuberculosis treatment, which appeared to have no impact on her symptoms, doctors write in a case report published in the National Library of Medicine.
The school teacher's sputum was tested for TB and was found to be negative. However, when her chest was scanned they found a lesion in the right upper lobe of her lungs. Upon further investigation, it appeared to be "an inverted bag-like structure ‘sitting’ in the bronchus".
The team removed the mysterious "bag". Though most of it was destroyed by the process, it was still identifiable as a condom.
For the layperson, "the lungs" are not in the top ten list of places you'd expect to find a condom. Doctors, understandably, did not just leave it there and asked a few more follow-up questions to get to the bottom of events.
"Retrospectively, both the husband and wife accepted to having undergone a fellatio," the team wrote in their report. "They could recollect that the condom had loosened during the act, and at that time, the lady had also experienced an episode of sneezing or coughing."
The team noted that diagnosis of the problem was delayed by several factors:
1) They believe that the condom itself was unlikely to cause a lung injury directly "due to its soft, elastic and rubbery consistency," but the obstruction could have led to build-ups of secretions, as well as infections. However, the way the condom flapped inside her lung during breathing and coughing likely cleared some secretions, leading to the delay of symptoms that could be seen by medical staff.
2) Embarrassment. The team writes that the couple may have been hesitant to disclose what had happened, or else genuinely didn't correlate inhaling a condom with subsequently developing a cough.
3) Given the age of the patient, the team did not consider inhalation of a foreign body as a possible explanation from the start.
The woman was expected to make a recovery, though small pieces of the condom were left in her lung following its tearing, making it likely that she may have to have a further bronchoscopy. The team believe that the case may be the only one of its kind in the medical literature.