Foreign Body Aspiration Differential Diagnoses

Updated: Oct 20, 2020
  • Author: Martin E Warshawsky, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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DDx

Diagnostic Considerations

Frequently aspirated objects include food (especially nuts and seeds), teeth, dental appliances, and medical instruments. The original event might have been forgotten. Choking with severe dyspnea, leading to respiratory or cardiac arrest while eating, might be initially misdiagnosed as myocardial ischemia.

Aspiration of live fish, leeches, and roundworms has been reported in the literature. A fish aspiration is usually a witnessed event or obvious on examination, however, endoparasites, such as freshwater leeches, are aspirated from direct contact with leech-infested waters most often in rural populations with limited access to clean drinking water. The most common presentation nosebleeds, pain or trouble swallowing, dyspnea, and hemoptysis. Leeches in the airway can mimic other respiratory ailments, such as bronchial asthma, and can be chronic in nature. Anemia is mostly found in children and can become severe enough to cause cardiorespiratory distress. [12]

Differential Diagnoses