A 4-year-old child presents with sudden onset severe respiratory distress, inability to speak, drooling, and sitting upright with neck extended. He is afebrile and has no cough. What is the most likely diagnosis?

• A Acute bronchiolitis
• B Foreign body aspiration ✓
• C Bacterial tracheitis
• D Retropharyngeal abscess

Explanation

Sudden onset respiratory distress with drooling, inability to speak, and no fever or cough in a previously well child is classic for foreign body aspiration. The absence of fever and cough differentiates it from infectious causes like epiglottitis, bacterial tracheitis, and retropharyngeal abscess. Bronchiolitis presents with gradual onset, fever, and wheeze. The sudden onset without prodrome is the key discriminating feature.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.