Why This Little Boy's Cough Sounds Like a Squeaky Toy

A four-year-old boy accidentally inhaled a whistle (B) which hindered air flow out of his lungs and caused his left lung to hyperinflate (A). (Image credit: The New England Journal of Medicine ©2018)

While most coughs sound hoarse or hacky, one young boy in India had a cough that squeaked.

Last year, the 4-year-old boy arrived at the doctor with a bizarre cough: one that sounded like the toots of a whistle. The boy's doctors described this curious case of the "whistling cough" in a new report, published today (Aug. 8) in The New England Journal of Medicine. (A video of the boy's cough can be found at that link.)

Doctors took an X-ray of the boy's chest, and saw that his left lung was hyperinflated, or blown up like a balloon. Such hyperinflation can be caused by something blocking the air passages to the lungs, or by certain medical conditions, such as asthma and cystic fibrosis, according to the Mayo Clinic

It was unclear from the X-ray whether something was indeed blocking some of the airflow in the boy's left lung. But if that were the case, air would be able to enter the lungs around the "mysterious object" lodged in one of his bronchi, or air passages, but would not be able to get out, leading to inflation, according to the report. [The 9 Most Bizarre Medical Conditions]

Assuming that this was the case, the doctors performed a bronchoscopy, a procedure that involves inserting a thin tube called a bronchoscope down through the throat and into the lungs.

Using this rigid tool, the doctors were able to find and remove the mysterious object, which turned out to be a toy whistle. Indeed, the little boy had been playing with the small whistle prior to the onset of his cough. It turns out, he accidentally inhaled it, and it ended up lodged in his lungs.

If it had been another foreign object lodged in his lungs, it would have caused noisy breathing or wheezing, but not a whistling sound, said report co-author Dr. Pirabu Sakthivel, a senior resident of head and neck surgery and oncology at the All India Institute of Medical Sciences in New Delhi.

"Foreign bodies in the airways are common," Sakthivel told Live Science. But the "whistling nature of cough is exceptionally rare."

A chest X-ray taken the next day showed that the boy's left lung had deflated back to normal. When the doctors followed up a year later, the boy's health was good, the report said. His lungs were no longer whistling.

Originally published on Live Science.

Yasemin Saplakoglu
Staff Writer

Yasemin is a staff writer at Live Science, covering health, neuroscience and biology. Her work has appeared in Scientific American, Science and the San Jose Mercury News. She has a bachelor's degree in biomedical engineering from the University of Connecticut and a graduate certificate in science communication from the University of California, Santa Cruz.