• Users Online: 64
  • Print this page
  • Email this page


 
 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 8  |  Issue : 2  |  Page : 114-115

All tachypnea is not coronavirus disease 2019: A child with neglected airway foreign body


1 Department of Pediatrics, Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Pediatric Surgery, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Submission02-Dec-2020
Date of Decision30-Dec-2020
Date of Acceptance09-Jan-2021
Date of Web Publication10-Mar-2021

Correspondence Address:
Dr. Suresh Kumar Angurana
Department of Pediatrics, Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpcc.jpcc_186_20

Rights and Permissions

How to cite this article:
Jogu S, Randhawa MS, Kanojia RP, Angurana SK. All tachypnea is not coronavirus disease 2019: A child with neglected airway foreign body. J Pediatr Crit Care 2021;8:114-5

How to cite this URL:
Jogu S, Randhawa MS, Kanojia RP, Angurana SK. All tachypnea is not coronavirus disease 2019: A child with neglected airway foreign body. J Pediatr Crit Care [serial online] 2021 [cited 2021 Apr 20];8:114-5. Available from: http://www.jpcc.org.in/text.asp?2021/8/2/114/311060



The focus of health-care professionals in the ongoing pandemic of coronavirus disease 2019 (COVID-19) has resulted in the occasional neglect of care for children with other treatable illnesses. Foreign-body aspiration (FBA) is a common medical emergency presenting to the pediatric emergency room (PER) with an incidence of 2–30/1,000,000.[1] Nearly 90% of Western patients aspirate organic materials, peanuts accounting for half of these; while bones were the most common in Southeast Asia and China.[2] The complications of a delayed diagnosis include dislodgement into deeper bronchi, chronic lung disease, pneumothorax, pneumonia, and lung abscess.[3] As children are unable to give a proper history, a high index of suspicion is necessary to diagnose FBA based on the characteristic history includes a choking or gagging episode followed by cough, wheezing, and stridor which has sensitivity of 86%–97%.[2],[3]

An 18-month-male presented with the sudden onset of cough and rapid breathing 2 weeks ago. He was taken to a nearby hospital where he was classified as severe acute respiratory illness and declined care due to a suspicion of COVID-19. Over the next 2 days, he visited 2 more nearby hospitals from where he was referred to a tertiary care hospital where he was admitted, screened for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and once negative transferred to the pediatric intensive care unit. Chest radiograph revealed right-sided pneumothorax [Figure 1]. He underwent right-sided intercostal drainage tube (ICDT) insertion, oxygen followed by mechanical ventilation for 5 days, and multiple antibiotics. Later, he developed left-sided pneumothorax for which another ICDT was inserted and referred to our center for further care. At the presentation to PER, a detailed history was elicited from the parents, which revealed that the symptoms started during feeding. FBA was suspected and he underwent rigid bronchoscopy on the emergency basis. An organic foreign body (white chickpea) was removed from the right main bronchus. Postprocedure, there was the resolution of respiratory distress. The ICDTs were removed, and he was extubated on day 2 and discharged after 4 days.
Figure 1: Chest X-ray showing right pneumothorax

Click here to view


Lockdown of services and human activities are claimed to be successful preventive measures for reducing the spread of SARS-CoV-2 infection.[4] As there are two sides to every coin, the lockdown has also led to unparalleled disruption of health-care services, limited transport of patients to higher centers for further care, pressure on health-care systems to prepare for the management, virtual closure of non-COVID-19 care, and missed diagnosis and management of other treatable conditions.[4],[5] Due to the fear of COVID-19, people are forced to stay at home, avoiding consultation for minor ailments, reduction in hospital visits for non-COVID-19-related conditions, resulting in worsening of common treatable disease and even death. Many factors probably led to the delayed diagnosis of FBA, causing life-threatening events. Due to the COVID-19 hysteria, a proper history may not have been elicited. All children with respiratory symptoms were assumed to be suffering from COVID-19. We wish to emphasize that all tachypnea is not COVID-19 and a careful clinical history and physical examination can identify these non-COVID-19 diseases.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Lowe DA, Vasquez R, Maniaci V. Foreign body aspiration in children. Clin Pediatr Emerg Med 2015;16:140-8.  Back to cited text no. 1
    
2.
Salih AM, Alfaki M, Alam-Elhuda DM. Airway foreign bodies: A critical review for a common pediatric emergency. World J Emerg Med 2016;7:5-12.  Back to cited text no. 2
    
3.
Rovin JD, Rodgers BM. Pediatric foreign body aspiration. Pediatr Rev 2000;21:86-90.  Back to cited text no. 3
    
4.
Signorelli C, Scognamiglio T, Odone A. COVID-19 in Italy: Impact of containment measures and prevalence estimates of infection in the general population. Acta Bio-Medica Atenei Parm 2020;91:175-9.  Back to cited text no. 4
    
5.
Mathew JL. Child health and delivery of care during the COVID-19 pandemic and beyond. Indian J Pediatr 2020;87:579-82.  Back to cited text no. 5
    


    Figures

  [Figure 1]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
References
Article Figures

 Article Access Statistics
    Viewed86    
    Printed0    
    Emailed0    
    PDF Downloaded17    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]