A history of recurrent wheezing can delay the diagnosis of foreign body aspiration in a paediatric emergency department.
Foreign body aspiration (FBA) into the airways is a potentially life-threatening event, and more frequent in children younger than 3 years of age; it can mimic other diseases by its frequently non-specific clinical and radiological presentation. The commonest misdiagnoses in children are asthma and recurrent respiratory tract infections with wheezing. This often makes it particularly difficult for a timely and proper diagnosis, especially when there is a silent history of FBA (not a rare occurrence in the age group at highest risk). We report a case of a 2-year-old boy who arrived at the emergency department at the Hospital of Ferrara, with dyspnoea, fever and wheezing, which had started 12 h after aspiration of a pistachio. The asymptomatic period after the pistachio aspiration, a history of recurrent wheezing during respiratory infections and the non-specificity of clinical and radiological findings, delayed the right diagnosis of FBA.
Department of Genetics and Pediatric Immunology, University Hospital of Messina, Messina, Italy.
Laura
L
Colavita
Department of Pediatrics, University Hospital "Sant'Anna" of Ferrara, Ferrara, Italy.
Claudia
C
Gelli
Department of Pediatrics, University Hospital "Sant'Anna" of Ferrara, Ferrara, Italy.
Lisa
L
Pecorari
Department of Pediatrics, University Hospital "Sant'Anna" of Ferrara, Ferrara, Italy.
Diego Giampietro
DG
Peroni
D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology; D001999:Bronchoscopy; D002675:Child, Preschool; D057210:Delayed Diagnosis; D004636:Emergency Service, Hospital; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009754:Nuts; D012008:Recurrence; D053120:Respiratory Aspiration; D012135:Respiratory Sounds / Q000175:diagnosis* / Q000209:etiology; D012189:Retrospective Studies