Question

A child is brought to the hospital with respiratory distress and biphasic stridor. The radiograph is shown below. What is the diagnosis?

• A. Acute epiglottitis
• B. Acute laryngotracheobronchitis
• C. Foreign body aspiration
• D. Laryngomalacia

Answer 1

The Correct Option is B

The child presenting with respiratory distress and biphasic stridor suggests an upper airway obstruction. The radiograph may exhibit characteristic features associated with these symptoms. Here is an analysis of the given options:

1. Acute epiglottitis: Typically presents with high fever, drooling, and difficulty swallowing. Radiographs show the classic "thumb sign" due to an enlarged epiglottis.
2. Acute laryngotracheobronchitis (Croup): Commonly seen in children, characterized by a barking cough and stridor. Radiographs show the "steeple sign" due to subglottic narrowing.
3. Foreign body aspiration: Can cause sudden respiratory distress and localized wheezing. Radiographic findings vary based on the object's location and type.
4. Laryngomalacia: Typically affects infants with intermittent stridor, worsening in supine positions. It's a structural condition, usually not seen on x-rays.

The symptoms of respiratory distress and biphasic stridor, coupled with radiographic findings of subglottic narrowing (not visible here but suggested), point towards Acute laryngotracheobronchitis as the diagnosis.