My Child Ate Foxtail Grass!
The Bottom Line
The flowering stems of wild grasses have a unique shape that allows them to be easily inhaled by humans or animals if they handle wild grass, put it in their mouths, or play in areas where wild grass grows. Aspiration of wild grass can cause coughing, respiratory irritation, and lung disease, such as pneumonia, that can be very difficult to diagnose and treat.
The Full Story
Grass is one of the world’s largest crops. It’s found nearly everywhere, even in the Arctic. Although different types of grass may appear similar to each other, many have unique identifying characteristics. There are many types of wild grass, including
- Foxtail
- Cattail
- Wheatgrass
- Rye grass
- Buffalo grass
- Timothy grass
- Wild oat
- Squirrel tail
- Sandbur
- Brome grass
- Foxtail barley
- Creep grass
- Hare barley
- False barley
- Yellow oatgrass
The flowering stems of wild grasses have a characteristic shape that is often called an “inflorescence” or “head”. The inflorescence contains a short barb-like structure called the grass awn. Grass awns have a short bristled section on one end, and a sharper stump on the other end. This unique structure of the grass awn allows it to easily move forward in only one direction when handled.
When inhaled into the body, grass awns can cause serious health problems. This is more commonly an issue in animals, including hunting and working dogs that exercise in fields with their mouths open. Humans may also inhale, or aspirate, grass awns into their lungs if they handle wild grass, put it in their mouths, or play in areas where wild grass grows. After aspiration, grass awns can move throughout the lungs and cause coughing, even coughing up blood, respiratory irritation, and pneumonia and other infections that are often long lasting, recurrent, and difficult to treat. In some cases, grass awns have been reported to work their way out of the body through the skin, many months after an aspiration event occurred.
Because children are often unable to describe or remember inhaling a foreign object, a history of exposure is often difficult to obtain, and this makes the diagnosis of grass awn aspiration especially challenging. A delayed or missed diagnosis can result in unnecessary testing, antibiotic administration, or hospitalization. Additionally, children may not exhibit signs or symptoms of respiratory irritation immediately after aspiration of a grass awn, and x-rays or CT scans may not reveal the presence of the foreign body. After the diagnosis is finally established, surgery may be required for removal of the grass awn. Due to the rare nature of this condition and the challenges associated with its diagnosis, any individual that has a chronic or unexplained lung infection should be evaluated for aspiration of a foreign object such as a grass awn.
If you have a question about poisoning from wild grass aspiration, get help online with webPOISONCONTROL® or call 1-800-222-1222. Both options are free for the public, and available 24 hours a day.
Kelly Johnson-Arbor, MD
Medical Toxicology Physician
Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- Handle wild grass, including foxtail, cattail, and other varieties, with care. Do not put it in your mouth.
- Do not allow children to play unsupervised in areas where wild grass grows.
- Consider foreign body, including grass awn, aspiration in any child with unexplained lung illness.
This Really Happened
A 13-year-old boy complained of right-sided chest pain and difficulty breathing. A chest x-ray was performed and revealed pneumonia. The pneumonia did not improve after treatment with antibiotics, so he was referred to a lung specialist who prescribed additional antibiotics and ordered a CT scan of his chest. Ten days later, he developed pus-like discharge from the skin on his back, and a surgical drain was placed. Four months later, he returned to the lung specialist and reported that a spike of grass was coming out of the area where the surgical drain had previously been placed. He then reported that, prior to the initial diagnosis of pneumonia, he thought he had swallowed a spike of grass while playing with it. Instead of swallowing the grass spike, he had likely inhaled it, and the grass spike likely traveled through his lungs until it migrated out through his skin. The grass spike was surgically removed, and he had no further symptoms.
For More Information
If you have a question about adverse reactions from itch mites or other bites or stings, get help online with webPOISONCONTROL or call 1-800-222-1222. Both options are free for the public, and available 24 hours a day.References
Allred KW. Describing the grass inflorescence. J Range Manag 1982;35(5):672-5.
Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- Handle wild grass, including foxtail, cattail, and other varieties, with care. Do not put it in your mouth.
- Do not allow children to play unsupervised in areas where wild grass grows.
- Consider foreign body, including grass awn, aspiration in any child with unexplained lung illness.
This Really Happened
A 13-year-old boy complained of right-sided chest pain and difficulty breathing. A chest x-ray was performed and revealed pneumonia. The pneumonia did not improve after treatment with antibiotics, so he was referred to a lung specialist who prescribed additional antibiotics and ordered a CT scan of his chest. Ten days later, he developed pus-like discharge from the skin on his back, and a surgical drain was placed. Four months later, he returned to the lung specialist and reported that a spike of grass was coming out of the area where the surgical drain had previously been placed. He then reported that, prior to the initial diagnosis of pneumonia, he thought he had swallowed a spike of grass while playing with it. Instead of swallowing the grass spike, he had likely inhaled it, and the grass spike likely traveled through his lungs until it migrated out through his skin. The grass spike was surgically removed, and he had no further symptoms.