A 22-month-old infant was referred for a possible inhaled foreign body after nonfatal choking with apple slices. He had a serious respiratory compromise including cough, choking, and cyanosis, leading to loss of consciousness resolving after several back blows and mouth-to-mouth resuscitation. Initial evaluation showed a persistent barking cough, inspiratory dyspnea, and stridor, with normal chest auscultation and chest radiographs. The infant had a history of persistent neonatal stridor, and previous choking with milk at 3-months-old with aspiration pneumonia, both linked to a laryngomalacia diagnosed after nasopharyngeal endoscopy. He then developed uncontrolled asthma with persistent wheezing, requiring emergency care once per month during the first winter. During the second year, stridor, often associated with expiratory wheezing, was audible only at the ends of meals, after an effort, or during respiratory infections. Cough during meals and dysphagia were also frequent.
Language: en
", language="en", issn="0022-3476", doi="10.1016/j.jpeds.2014.06.067", url="http://dx.doi.org/10.1016/j.jpeds.2014.06.067" }