Factors associated with early diagnosis:
(1) witnessed choking episode
(2) sudden onset of cough, dyspnea and/or wheezing (symptomatic)
(3) lateralizing signs
(4) prompt evaluation
Factors that may delay the diagnosis:
(1) not pursuing the diagnosis because physical and initial X-ray studies are normal
(2) pre-existing explanation for symptoms
(3) misdiagnosis as asthma, pneumonia or common cold
The presence of an unexplained persistent cough and/or refractory pulmonary infiltrates in a small child should always prompt evaluation for foreign body aspiration.
Additional factors that may contribute to delayed diagnosis:
(1) poor level of care, including negligence
(2) absence of persistent symptoms
