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To the Editor.
We read with interest the case report of a child with a penny lodged in the esophagus by Bothwell et al.1 In our pediatric otolaryngology and anesthesia practice, we see a number of such patients annually. Before diagnosis of chronic esophageal foreign bodies, it is not unusual for some of these children to have been treated for new-onset asthma for several weeks to months. Most often, the "asthma" resolves following removal of the foreign body. Although reactions as severe as that described by the authors in their case report have not been seen, almost all have some esophageal mucosal and/or muscular reaction to the presence of the penny, especially if it has been present for more than a few days.
Our concern with this report and discussion is the emphasis on zinc toxicity in this patient despite neither a documented zinc