Chronic ingestion of a zinc-based penny

In the early 1970s the cost of using a copper alloy in the minting of US pennies was becoming greater than the value of the penny itself. Initially, a very inexpensive aluminum penny was proposed as a replacement to the copper alloy. However, it was never distributed because of its poor radiographic appearance after ingestion as well as the vending machine industry’s concern that the lightweight penny would cause mechanical difficulty.1,2 Because of the high prevalence of coin ingestion particularly among the pediatric population, a radiodense zinc penny was the next alternative to the original copper alloy (Fig 1). Since 1982, the US Mint has produced a penny composed mostly of zinc with a thin copper coating (0.0003 inches thick).1 Although the post-1982 penny is easily seen on radiographs, zinc is highly reactive with gastric acid, and causes local corrosion and potentially systemic toxicity. This case report presents a child with a chronically ingested post-1982 penny that was lodged in the esophagus for at least 4 months before a radiograph identified its presence. Fig 1. Cross-sectional view of pre-1982 (above) and post-1982 penny (below). The post-1982 penny demonstrates the thin copper coating overlying the zinc core. Our 14-month-old patient presented to the emergency department with a 1-day history of a high fever. His mother reported a 48-hour history of coryza and general malaise but denied any significant change in the child’s appetite or diet. His mother also reported a chronic “raspy” cough for approximately 4 months. This cough had been the source of numerous visits to the child’s primary care clinic where he had been treated for multiple presumed upper respiratory infections. His mother was unable to give details about the onset of this cough as the child was living with his father before this … Reprint requests to (E.A.M.) Pediatric Otolaryngology Service, Wilford Hall USAF Medical Center, 2200 Bergquist Dr, Ste 1, San Antonio, TX 78236-6569. E-mail: eric.mair{at}lackland.af.mil