An unusual cause of pneumonia: seen but not heard.

A 75-year-old man presented with a non-resolving pneumonia, malaise and weight loss. His medical history included a squamous cell carcinoma of the larynx and a non-small cell carcinoma of the lung. Chest CT showed right lower lobe collapse and consolidation. Bronchoscopy identified a foreign body in the right main bronchus and was subsequently removed with rigid bronchoscope. The removed foreign body was identified as a Blom-Singer speaking valve which had been aspirated 3 months previously. This is a rare complication of a speaking valve aspiration. This case illustrates the potential differential diagnoses of retained foreign bodies in the lung and that the symptoms can mimic neoplastic disease. Once removed, patients can have a dramatic improvement in quality of life and it is important to remember that a speaking valve may be aspirated, even if one present on the initial examination!