Acute stridor / noisy breathing :
- Stridor indicates an upper airway problem.
- Look for a history of foreign body aspiration and signs of toxicity.
Important differentials:
-
Croup : Non toxic , viral prodrome , barking cough.
X ray neck shows - steeple sign. -
Epiglottitis : Toxic child, drooling saliva.
Lateral X ray neck shows thumb sign. -
Diphtheria : cervical lymph nodes ( bull neck ) , dirty grey or white membrane and un immunized.
-
Foreign body aspiration: choking, decreased air entry, unilateral hyperinflation.