What is the most likely diagnosis for an 11-month-old boy with acute worsening cough, intermittent wheezing, and a family history of asthma?

In this scenario, the child’s symptoms of acute worsening cough, intermittent wheezing, and the family history of asthma suggest the possibility of a reactive airway disease. While bronchiolitis and croup are conditions that can also be considered in young children with respiratory symptoms, the key here is the acute nature of the symptoms and the family history indicating a predisposition to asthma.

Foreign body aspiration is a plausible diagnosis given the age of the child and the sudden increase in respiratory distress. Infants and toddlers are particularly susceptible to this due to their tendency to explore objects orally. Symptoms such as a sudden onset of cough, wheezing, or stridor can occur when an object obstructs the airway, leading to acute respiratory distress. The intermittent wheezing is particularly indicative of a foreign body, as it may lead to localized airway obstruction resulting in wheezing rather than a diffuse process, which would generally be expected with conditions like bronchiolitis or pneumonia.

While pneumonia might present similarly with cough and respiratory distress, it usually involves a more insidious onset with potential fever and can be accompanied by signs of systemic illness, which are not mentioned here. Croup is typically characterized by a distinctive "barking" cough and stridor, often accompanied by a history