{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:48:08Z","timestamp":1788306488303,"version":"build-2803163510"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":32,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Paediatric Research Center of New Children\u2019s Hospital, Helsinki, Finland"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pediatrics"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    . Paediatric healthcare specialists are concerned about the secondary effects of the COVID\u201019 pandemic on children. We report a case of acute respiratory distress in a healthy toddler whose healthcare providers were sidetracked from the correct diagnosis by suspicion of COVID\u201019.\n                    <jats:italic>Case Presentation<\/jats:italic>\n                    . The patient was a 20\u2010month\u2010old healthy boy. In the morning, he had coughed while drinking milk. He was asymptomatic for the day but presented with acute respiratory distress when lying down in the evening. An ambulance was called, and he was taken to a tertiary hospital\u2019s paediatric emergency department, where his condition and oxygen saturation fluctuated. He had mildly elevated temperature and petechiae on his trunk, showed asymmetrical radiographic and auscultatory pulmonary findings, and did not tolerate any exertion. Pneumonia was suspected, SARS\u2010CoV\u20102 was considered as potential causative agent, and the child was admitted to a Paediatric Intensive Care Unit. As the patient did not show clear signs of infection or bronchial obstruction, the events were thoroughly rediscussed with the caregiver next morning. It was then found out that the child had also been eating cashew nuts. Multiple pieces of cashew nuts were removed from the left bronchial tree in a bronchoscopy. After the procedure, all symptoms promptly resolved. Foreign body aspiration\u2014an obvious cause of acute respiratory distress in our patient\u2019s age group\u2014was overlooked by experienced emergency medical care providers and paediatric critical care physicians due to the slightly unusual presentation, incomplete anamnestic information, and a bias to consider COVID\u201019 in the current exceptional circumstances.\n                    <jats:italic>Conclusions<\/jats:italic>\n                    . Emergency care providers are instructed to consider all patients with respiratory distress as potential COVID\u201019 patients. However, the clinical course of COVID\u201019 infection is usually mild in children. Therefore, alternative causes for serious breathing difficulty are more likely, and all differential diagnoses should be considered in the usual unbiased manner.\n                  <\/jats:p>","DOI":"10.1155\/2021\/8855962","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T17:35:14Z","timestamp":1612287314000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Overlooking the Obvious during the COVID\u201019 Pandemic: Dyspnoea with Asymmetric Breath Sounds in a Toddler"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0565-0593","authenticated-orcid":false,"given":"Heli","family":"Salmi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heini","family":"Harve-Ryts\u00e4l\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Rautiainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Py\u00f6r\u00e4l\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"H\u00e4stbacka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmc2005073"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0702"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapaediatrics.2020.1467"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2007617"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2020.25.18.2000600"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0961"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(20)30108-5"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1669"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2020-000701"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200x.2012.03610.x"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/1478795"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.12.90"}],"container-title":["Case Reports in Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cripe\/2021\/8855962.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cripe\/2021\/8855962.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2021\/8855962","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T17:06:40Z","timestamp":1764868000000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2021\/8855962"}},"subtitle":[],"editor":[{"given":"Miguel","family":"O Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1155\/2021\/8855962"],"URL":"https:\/\/doi.org\/10.1155\/2021\/8855962","archive":["Portico"],"relation":{},"ISSN":["2090-6803","2090-6811"],"issn-type":[{"value":"2090-6803","type":"print"},{"value":"2090-6811","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"assertion":[{"value":"2020-08-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8855962"}}