Aspiration of inflorescence or grass heads (seed head of grasses) ofte
n presents with atypical signs and symptoms because grass heads have a
tendency to rapidly migrate to the periphery of the lung. If this is
not recognized, it can lead to delay in diagnosis and serious complica
tions. Removal with rigid bronchoscopy maybe difficult, and surgery is
often needed. We report a case of a seven-month-old child who had a d
elayed diagnosis of grass head aspiration and subsequently presented w
ith a life threatening tension pneumothorax. This case highlights the
importance of obtaining a detailed history in cases of foreign body as
piration and the need to include it in the differential diagnosis of u
nexplained respiratory symptoms, especially those of sudden onset in c
hildren.