The foreign body reaction elicited depends on the nature of the foreign body. Organic foreign bodies, especially nuts, cause a very severe reaction. Unfortunately, the choking episodes are often disregarded or unwitnessed by parents. The symptoms and signs of aspiration may be subtle and non-specific, especially soon after the episode. The history of a choking episode is usually available, even when children present late, though the parents may not immediately recall or volunteer this information.
Later presentations are usually due to the asymptomatic latent period.
The classic clinical triad of foreign body aspiration is wheezing, cough and absent or diminished breath sounds. Most children are first seen for non-specific symptoms like cough, wheeze, stridor, breathlessness, sputum production and haemoptysis. Fever may be present, and some children may have vomiting. Some children, if seen during the latent period, may be asymptomatic. The symptoms of foreign body aspiration vary according to the location and type of foreign body and on the duration since aspiration.