Difference between revisions of "Template:Pediatric stridor DDX"

(Created page with "===Pediatric stridor=== ===<6mo=== *Laryngotracheomalacia *Vocal cord paralysis (weak cry) *Subglottic stenosis (previous intubation) *Airway hemang...")
 
(Pediatric stridor)
 
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===[[Stridor (Peds)|Pediatric stridor]]===
 
===[[Stridor (Peds)|Pediatric stridor]]===
 +
 
===<6mo===
 
===<6mo===
 
*[[Laryngotracheomalacia]]
 
*[[Laryngotracheomalacia]]
*Vocal cord paralysis (weak cry)
+
**Accounts for 60%
*[[Subglottic stenosis]] (previous intubation)
+
**Usually exacerbated by viral URI
*Airway hemangioma (usually regresses by age 5)
+
**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
 
*[[Vascular ring]]/sling
  
 
====>6mo====
 
====>6mo====
 
*[[Croup]]
 
*[[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]]
 
*[[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]]
 
*[[Bacterial tracheitis]]
*[[Foreign body]] (sudden onset, asymmetric)
+
**Rare but causes life-threatening obstruction
*[[Retropharyngeal abscess]] (muffled voice, fever)
+
**Sx 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

Latest revision as of 16:23, 1 July 2020

Pediatric stridor

<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
    • Fever, neck pain, dysphagia, muffled voice, drooling, neck stiffness/torticollis/extension