Romanian JouRnal of PediatRics – Volume 71, no. 3, 2022 144 ABSTRACT Foreign body aspiration represents one of the main causes of rising morbidity and mortality in children, mostly for the toddlers’ category of age. Both acute and silenced manifestation of this phenomena determines an immediate attitude in the management of the child in question. We present you a clinical case of a 2 years and 8 months old patient, diag- nosed with sunflower seed coat aspiration, through flexible bronchoscopy. The implemented treatment consisted in rigid bronchoscopy and extraction of the foreign body. Keywords: foreign body aspiration, toddler, bronchoscopy Foreign body aspiration: approach and therapeutic management Andreia Mihaela Condrea 2 , Liana Lupsa 2 , Alina Corina Grama 1,2 1 ”George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania 2 Department of Pediatrics I, Clinical County Emergency Hospital, Targu Mures, Romania CASE REPORTS Ro J Pediatr. 2022;71(3) DOI: 10.37897/RJP.2022.3.4 Corresponding author: Alina Corina Grama E-mail: alinagrama24@yahoo.com Article History: Received: 22 September 2022 Accepted: 26 September 2022 InTRoduCTIon Foreign body aspiration is a medical emergency with a high fatal risk which requires an appropriate management and a rapid establishment of thera- peutic procedures in order to minimize the onset of eventually life-threatening complications. Accord- ing to guidelines, children aged between 1 and 3 years old are the most likely to accidentally inhale food and non-food items, in absence of an attentive and adequate supervising. When it comes to tod- dlers, nuts, seeds and beans represent the most fre- quently encountered types of foreign bodies. The obstruction can happen at any level of the respira- tory tract, consequently, signs and symptoms can vary from the loudest to the subtlest ones, being, thus, interpreted frequently such as other respira- tory diseases [1,2]. An adequate anamnesis along with a rigorous clinical examination could offer im- portant clues about the etiology of the respiratory disfunction. Nevertheless, investigations, such as imagistics and exploratory bronchoscopy, in par- ticular cases, are the ones which sustain the pre- sumptive diagnosis. The treatment consists of re- moving the foreign body from the respiratory tract through minimal invasive endoscopic ways [3]. CASe pReSenTATIon We present the case of a 2 years and 8 months old female toddler, who was admitted to The Pediatric Department of The Clinical County Emergency Hos- pital of Targu Mures, for fever associated with pro- ductive cough, with an onset 7 days before the hos- pital admission, without favorable evolution under symptomatic treatment given at home. Regarding patient’s medical history, she is affirmatively known with perinatal hypoxia, septal atrial defect, patent arterial duct, left ventricular hypertrophy and re- current respiratory infections. The mother confirms that the toddler is incompletely vaccinated accord- ing to The National Calendar of Vaccination. CLInICAL FIndInGS At the admission, the clinical exam showed the toddler had an altered general condition, fever