Published online May 1, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. e1057-e1060 (doi:10.1542/peds.2005-2196)
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EXPERIENCE & REASON

Persistent Cough and Failure to Thrive: A Presentation of Foreign Body Aspiration in a Child With Asthma

Amir Kugelman, MDa, Ron Shaoul, MDa, Moshe Goldsher, MDb and Isaak Srugo, MDa

a Department of Pediatrics, Bnai Zion Medical Center, The B. Rappaport Faculty of Medicine, Haifa, Israel
b Department of Otolaryngology, Bnai Zion Medical Center, The B. Rappaport Faculty of Medicine, Haifa, Israel

ABSTRACT

Severe failure to thrive (FTT) in a child with asthma and a persistent cough should not be explained solely by asthma and warrants a thorough and prompt evaluation. The finding of a foreign body in our case was surprising, because it does not usually present as or lead to FTT. Good clinical judgment and habits could prevent the course of events that we described in this case. Following are the key lessons to be learned from this presentation: (1) maintain a high index of suspicion for foreign body aspiration, even in toddlers with asthma, (2) pay special attention to a child with FTT, (3) be aware of localizing findings on physical examination and chest radiographs, and (4) perform a chest radiograph no later than after 1 month of chronic cough.

Key Words: asthma • cough • failure to thrive • foreign body

Abbreviations: FTT, failure to thrive • FBA, foreign body aspiration

Accepted Nov 8, 2006.