Foreign Body Aspiration: Potential Cause of Coughing and Wheezing
H. James Holroyd MD1
1 Clinical Professor of Pediatrics, University of Southern California, Descanso Pediatric Medical Group, 1346 Foothill Blvd, La Canada, CA 91011
As many as half of routine ill-patient visits in pediatrics practice involve respiratory symptoms. It is not surprising that we see so much coughing and wheezing when we consider that children are still developing immunologically and are, therefore, more susceptible to infection. In early life, most of these infectious diseases occur in the respiratory and gastrointestinal tracts. In addition, the gradual exposure of the constitutionally allergic child to environmental allergens pre-disposes to the development of respiratory symptoms. Childhood is also a time for congenital defects of the cardiopulmonary system to become apparent.
A sometimes overlooked cause of respiratory symptoms in infants and young children—and one that can become rapidly and severely complicated if misdiagnosed—is the aspiration of foreign bodies. Aspiration or ingestion of foreign bodies remains a significant cause of morbidity and mortality in the pediatric population. Children between 8 months and 4 years of age are at highest risk. Not all cases of aspiration are of the acute, obstructive variety, and pediatricians should consider a foreign body as a possible cause of coughing and wheezing even when no definite history of aspiration is obtained.
Children of course are curious and their natural tendency is to reach out and explore new objects. Bringing objects to their mouths to taste and to test textures is common.
