A case report is presented of a 10-month-old child with a 1-month hist
ory of respiratory symptoms, followed by 3 to 4 days of fever, progres
sing to poor feeding, vomiting, and weight loss. The child is cared fo
r by his mentally disabled young parents. A chest radiograph revealed
a metallic foreign body obstructing the proximal esophagus. Esophagosc
opy and removal of a penny re suited in immediate resolution of the ac
ute gastrointestinal symptoms; the respiratory symptoms resolved short
ly thereafter. Diagnostic and therapeutic considerations in the manage
ment of pediatric aerodigestive foreign bodies are discussed. High-ris
k parenting, such as in this case, is a risk factor for pediatric fore
ign-body ingestion.