Foreign body (FB) aspiration is common in infants and younger children with a high incidence in toddlers as they use their mouth to explore the surroundings. It can lead to high mortality and morbidity if it remains undiagnosed and unaddressed appropriately in time. 1,2 The most common types of FB aspiration in children are seeds, peanuts, food particles, and toys. Items such as coins, paper clips, pins, and pen caps are usually noticed to be aspirated in older children. 3,4 The diagnosis of FB aspiration in airways is difficult in cases with an uncharacterized medical history and discrete symptoms. Delay in the diagnosis of a FB is mainly due to parents not witnessing the choking crisis along with failure to diagnose the condition by the primary physician because of its atypical presentation and misleading radiological findings, which often leads to therapeutic challenges. 5 Aspiration of organic FB leads to airway mucosal inflammation and edema in the acute stage. Further, if FB in airways is missed, granulation tissue forms, which later on can lead to symptoms masquerading difficult bronchial asthma along with recurrent/persistent pneumonia. Here, we report an 11-year-old child with FB aspiration who initially was misdiagnosed and treated as asthmatic patient. Later on, he was diagnosed to have FB in the right bronchus, which was successfully removed by flexible bronchoscopy. 2 | CASE REPORT An 11-year-old boy was brought to the pediatric outpatient department with complaints of recurrent cough, tightness of chest, and breathing difficulty for the last 18 months. The child was a product of nonconsanguineous parents. The child was asymptomatic 18 months prior and doing well. Developmentally, he was normal, and his scholastic performances were normal. There was no reported family history of asthma or tuberculosis. Eighteen months back, the child developed sudden-onset cough, wheeze, and fever for which he was diagnosed as pneumonia and treated with oral antibiotics (amoxicillin-clavulanic acid) and bronchodilators (oral salbutamol syrup; nebulization-salbutamol, ipratropium bromide, and budesonide) by his local pediatrician. Chest X-ray showed right-sided hyperinflation (Figure 1A). The child responded well to the above treatment. Later on, the child had repeated reoccurrence of symptoms for which he received several courses of oral antibiotics (amoxicillin-clavulanic acid) along with bronchodilators (oral salbutamol syrup)
