Difference between revisions of "Template:Pediatric stridor DDX"

(>6mo)
(>6mo)
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**Sx of croup + toxic-appearing = bacterial tracheitis
 
**Sx of croup + toxic-appearing = bacterial tracheitis
 
*[[Foreign body]] (sudden onset)
 
*[[Foreign body]] (sudden onset)
 +
**Marked variation in quality or pattern of stridor
 
*[[Retropharyngeal abscess]] (muffled voice, fever)
 
*[[Retropharyngeal abscess]] (muffled voice, fever)

Revision as of 17:05, 23 June 2019

Pediatric stridor

  • A minimal amount of edema or inflammation in the pediatric airway can result in significant obstruction
    • Can lead to rapid decompensation

<6mo

  • Laryngotracheomalacia
    • Accounts for 60%
    • Usually exacerbated by viral URI
    • Dx w/ flexible fiberoptic laryngoscopy
  • Vocal cord paralysis
    • Stridor associated w/ feeding problems, hoarse voice, weak and/or changing cry
    • May have cyanosis or apnea if bilateral (less common)
  • Subglottic stenosis
    • Congenital vs 2/2 prolonged intubation in premies
  • Airway hemangioma
    • Usually regresses by age 5
    • Associated w/ skin hemangiomas in beard distribution
  • Vascular ring/sling

>6mo

  • 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
  • Bacterial tracheitis
    • Rare but causes life-threatening obstruction
    • Sx of croup + toxic-appearing = bacterial tracheitis
  • Foreign body (sudden onset)
    • Marked variation in quality or pattern of stridor
  • Retropharyngeal abscess (muffled voice, fever)