A 2-year-old child was eating peanuts when he suddenly developed choking, gagging, and coughing. He now has persistent unilateral wheeze and decreased breath sounds on the right side. What is the most likely diagnosis?
- A Foreign body aspiration ✓
- B Acute asthma exacerbation
- C Bacterial pneumonia
- D Viral bronchiolitis
Correct answer: A. Foreign body aspiration
Explanation
The sudden onset of choking while eating, followed by unilateral wheeze and decreased breath sounds, is classic for foreign body aspiration. The right main bronchus is more commonly involved due to its more vertical course. Asthma and bronchiolitis typically cause bilateral wheeze. Pneumonia would present more gradually with fever and bilateral findings.
Reference: Nelson Textbook of Pediatrics, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.