A foreign body in an infant airway

An otherwise healthy infant presented to the emergency department (ED) with a history of screaming and sudden hoarseness. Lateral neck and chest radiographs were obtained that did not demonstrate a radiopaque foreign body within the upper or lower airway. The child was otherwise stable during his stay in the ED, with persistent, but periodic stridor and cough, unresponsive to albuterol nebulizers. The child was brought to the operating room for direct laryngoscopy and bronchoscopy to rule out an airway foreign body. Upon exposing the larynx, a bluish-colored foreign body was seen in a vertical orientation obstructing nearly the entire subglottis with significant granulation in the subglottic region (Figure 1). Further examination of the object revealed it to be an artificial fingernail.