Suraj Gupte Differential Diagnosis in Pediatrics Fifth Edition PDF Download
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Suraj Gupte Differential Diagnosis in Pediatrics Fifth Edition
Stridor is an inspiratory sound due to narrowing of the upper airway. Mohammed is most likely to have stridor due to laryngomalacia. This means that the laryngeal cartilage is soft and floppy, with an abnormal epiglottis and/or arytenoid cartilages.
The larynx collapses and narrows during inspiration (when there is a negative intrathoracic pressure), resulting in inspiratory stridor. It is usually a benign condition with noisy breathing but no major problems with feeding or significant respiratory distress. Most cases resolve spontaneously within a year as the larynx grows and the cartilaginous rings stiffen.
The reason Mohammed now has respiratory distress is that he has an intercurrent viral upper respiratory tract infection.A very important diagnosis to consider in this boy is a haemangioma in the upper airway.
The majority of haemangiomas are single cutaneous lesions, but they can also occur at other sites and the upper airway is one position where they can enlarge with potentially life-threatening consequences.
The presence of one haemangioma increases the likelihood of a second one. This boy should be referred for assessment by an ENT surgeon.