Acute stridor / noisy breathing

Acute stridor / noisy breathing :

  • Stridor indicates an upper airway problem.
  • Look for a history of foreign body aspiration and signs of toxicity.

Important differentials:

  1. Croup : Non toxic , viral prodrome , barking cough.
    X ray neck shows - steeple sign.

  2. Epiglottitis : Toxic child, drooling saliva.
    Lateral X ray neck shows thumb sign.

  3. Diphtheria : cervical lymph nodes ( bull neck ) , dirty grey or white membrane and un immunized.

  4. Foreign body aspiration: choking, decreased air entry, unilateral hyperinflation.