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The Case of the “Picky” Eater: Accidental Toothpick Ingestion Manifesting as Abdominal Wall Cellulitis

McIntosh, Lacey J. DO, MPH; Martone, Catharine MD; Rapose, Alwyn MD

Infectious Diseases in Clinical Practice: January 2013 - Volume 21 - Issue 1 - p 54–55
doi: 10.1097/IPC.0b013e3182602038
Case Reports

Foreign body ingestion leading to visits to the emergency department is more frequent in the pediatric age group. Most ingested objects are passed out in the stools. However, ingestion of pointed objects could result in severe complications. Our case is a 93-year-old woman who presented with abdominal wall cellulitis and abscess confirmed on computed tomographic scan. Bedside drainage revealed an intact toothpick. Cultures grew intestinal organisms including Bacteroides fragilis, confirming the presence of an enterocutaneous fistula. Laparotomy for surgical excision of the fistula was deemed very high risk, and the patient opted for conservative management. One year later, she is in complete recovery.

From the Saint Vincent Hospital, Reliant Medical Group, Worcester, MA.

Correspondence to: Alwyn Rapose, MD, Division of Infectious Diseases, Reliant Medical Group, Worcester, MA 01608. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2013 Lippincott Williams & Wilkins, Inc.