Template:Pediatric stridor DDX: Difference between revisions
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===[[Stridor (Peds)|Pediatric stridor]]=== | ===[[Stridor (Peds)|Pediatric stridor]]=== | ||
===< | ====<6 Months Old==== | ||
*[[Laryngotracheomalacia]] | *[[Laryngotracheomalacia]] | ||
**Accounts for 60% | **Accounts for 60% | ||
**Usually exacerbated by viral URI | **Usually exacerbated by viral URI | ||
** | **Diagnosed with flexible fiberoptic laryngoscopy | ||
*Vocal cord paralysis | *Vocal cord paralysis | ||
**Stridor associated | **Stridor associated with feeding problems, hoarse voice, weak and/or changing cry | ||
**May have cyanosis or apnea if bilateral (less common) | **May have cyanosis or apnea if bilateral (less common) | ||
*[[Subglottic stenosis]] | *[[Subglottic stenosis]] | ||
**Congenital vs | **Congenital vs secondary to prolonged intubation in premies | ||
*Airway hemangioma | *Airway hemangioma | ||
**Usually regresses by age 5 | **Usually regresses by age 5 | ||
**Associated | **Associated with skin hemangiomas in beard distribution | ||
*[[Vascular ring]]/sling | *[[Vascular ring]]/sling | ||
====> | ====>6 Months Old==== | ||
*[[Croup]] | *[[Croup]] | ||
**viral laryngotracheobronchitis | **viral laryngotracheobronchitis | ||
**6 mo- 3 yr, peaks at 2 yrs | **6 mo - 3 yr, peaks at 2 yrs | ||
**Most severe on 3rd-4th day of illness | **Most severe on 3rd-4th day of illness | ||
**Steeple sign not reliable- diagnose clinically | **Steeple sign not reliable- diagnose clinically | ||
*[[Epiglottitis]] | *[[Epiglottitis]] | ||
**H flu type B | **[[H flu]] type B | ||
***Have higher suspicion in unvaccinated children | ***Have higher suspicion in unvaccinated children | ||
**Rapid onset sore throat, fever, drooling | **Rapid onset sore throat, fever, drooling | ||
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*[[Bacterial tracheitis]] | *[[Bacterial tracheitis]] | ||
**Rare but causes life-threatening obstruction | **Rare but causes life-threatening obstruction | ||
** | **Symptoms of croup + toxic-appearing = bacterial tracheitis | ||
*[[Foreign body]] (sudden onset) | *[[Foreign body]] (sudden onset) | ||
**Marked variation in quality or pattern of stridor | **Marked variation in quality or pattern of stridor | ||
*[[Retropharyngeal abscess]] | *[[Retropharyngeal abscess]] | ||
**Fever, neck pain, dysphagia, muffled voice, drooling, neck stiffness/torticollis/extension | **Fever, neck pain, dysphagia, muffled voice, drooling, neck stiffness/torticollis/extension | ||
Latest revision as of 19:40, 17 January 2024
Pediatric stridor
<6 Months Old
- Laryngotracheomalacia
- Accounts for 60%
- Usually exacerbated by viral URI
- Diagnosed with flexible fiberoptic laryngoscopy
- Vocal cord paralysis
- Stridor associated with feeding problems, hoarse voice, weak and/or changing cry
- May have cyanosis or apnea if bilateral (less common)
- Subglottic stenosis
- Congenital vs secondary to prolonged intubation in premies
- Airway hemangioma
- Usually regresses by age 5
- Associated with skin hemangiomas in beard distribution
- Vascular ring/sling
>6 Months Old
- Croup
- viral laryngotracheobronchitis
- 6 mo - 3 yr, peaks at 2 yrs
- Most severe on 3rd-4th day of illness
- Steeple sign not reliable- diagnose clinically
- Epiglottitis
- H flu type B
- Have higher suspicion in unvaccinated children
- Rapid onset sore throat, fever, drooling
- Difficult airway- call anesthesia/ ENT early
- H flu type B
- Bacterial tracheitis
- Rare but causes life-threatening obstruction
- Symptoms of croup + toxic-appearing = bacterial tracheitis
- Foreign body (sudden onset)
- Marked variation in quality or pattern of stridor
- Retropharyngeal abscess
- Fever, neck pain, dysphagia, muffled voice, drooling, neck stiffness/torticollis/extension