Case history

Case history #1

An 82-year-old man suddenly choked while eating loquat fruits at home. The patient subsequently presented to the emergency department with a severe cough. His physical examination was normal except for localised wheezing in the right lower lung field, best heard anteriorly. There were no focal neurological deficits and no significant past medical history. However, the patient's wife stated that he often coughed while eating.

Case history #2

A 3-year-old boy was playing with colourful interlocking plastic bricks, when he suddenly started coughing and gagging. The child subsequently developed a high-pitched sound and his breathing became laboured. The child's carer called the paramedics, but while waiting for the ambulance, the child's breathing slowed and he became unconscious.

Other presentations

Patients with aspirated foreign bodies may present with acute asphyxiation and respiratory arrest, or may have only non-specific symptoms such as dyspnoea or cough. Unilateral wheezing suggests partial airway obstruction of the main or distal bronchi. Some patients may present with no memorable history of an aspiration event and yet present with a chronic cough, wheeze, pulmonary mass, lung abscess, or other misdiagnosed respiratory diagnosis, such as asthma.[2][3][4][5]

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