A typical presentation of a laryngeal foreign body in an infant

Background: A 1-year-old boy presented with a one-day history of fever and cough, potentially linked to an episode of aspiration during homemade rice feeding. Following the incident, he refused to feed, displaying irritability. The detection of neutrophil leucocytosis and dehydration prompted IV antibiotics and fluid. Persistent symptoms led to a lateral neck x-ray, revealing a radiopaque material near the epiglottis. Fibre optic laryngoscopy identified a metallic wire lodged in the right arytenoid cartilage and posterior pharyngeal wall, possibly a fragment from a rice polishing machine. Extraction under general anaesthesia resulted in minimal mucosal injury, and the child quickly recovered postoperatively.Conclusion: This report serves as a reminder to consider foreign body ingestion in the differential diagnosis, particularly in cases with subtle or unrelated symptoms in the paediatric age group. The multidisciplinary approach emphasises prompt intervention to prevent life-threatening complications in paediatric patients. Furthermore, employing awake fibre-optic laryngoscopy in the context of a suspected respiratory tract infection to confirm the presence of a foreign body is considered a clinically safer approach than immediately resorting to examination under anaesthesia.