While coughing can have strange sounds - from raspy to stuttering, this boy's cough had an unusual one - whistling.
A case report in the New England Journal of Medicine, reveals how the boy was brought to an otorhinolaryngology out-patient clinic after he had a "2-day history of persistent cough" which had "an intermittent whistling character."
It also revealed how "the patient had no history or symptoms of viral infection of the upper respiratory tract, and he otherwise felt well."
An X-Ray of the boy's chest revealed how his left lung was hyper-inflated, or blown up like a balloon.
This kind of hyperinflation, according to Live Science can be caused by something blocking air passage to the lung, or by certain medical conditions, such as asthma and cystic fibrosis.
However, since it was unclear from the X-ray whether something was indeed blocking some of the airflow in the boy's left lung. If it indeed was 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.
To confirm, the doctors performed a bronchoscopy, which is a procedure that involves inserting a thin tube called a bronchoscope down the throat and into the lungs. This led to the doctors discovering and retrieving the mysterious object - which turned out to be a toy whistle.
His parents reported that he had been playing with a whistle before the cough began, and turns out that the boy had at some point accidentally inhaled it, and it ended up being lodged in his lungs.
A video shared by the New England Journal of Medicine's twitter shows the young boy's strange cough.
A 4-year-old boy presented to the otorhinolaryngology outpatient clinic with a 2-day history of a whistling cough, shown in a video. Bronchoscopy was performed, and an aspirated toy whistle was retrieved.— NEJM (@NEJM) August 15, 2018
A 4-year-old boy makes a whistling sound while coughing. Bronchoscopy was performed, and an aspirated toy whistle was retrieved. https://t.co/73J1tdVZEh pic.twitter.com/1AfFr1KKPz — NEJM (@NEJM) August 10, 2018
"Foreign bodies in the airways are common," Dr Pirabu Sakthivel, a senior resident of head and neck surgery and oncology at AIIMS, told Live Science. "But the "whistling nature of cough is exceptionally rare."
A radiograph of a 4-year-old boy’s chest revealed that his persistent whistling cough was due to a toy whistle obstructing his left segmental bronchus. The foreign object was retrieved and a follow-up radiograph showed resolution of the hyperinflation. https://t.co/aquFAoWEdt pic.twitter.com/RvU1fhwxGG— ASRT (@ASRT) August 13, 2018
The child remained well at his one-year follow-up visit, according to the report.
Earlier, doctors had found shaving blades, needles, chain and 263 coins inside a man's stomach in Madhya Pradesh.