R. NICKBRYANMDS. JAMESZINREICHMD
A 25-MONTH-OLD girl who was transferred to our institution from an outside hospital presented with a clinical history of repeated inspiratory stridor episodes, without signs of respiratory compromise, that were preceded by upper respiratory tract infections. Exposure to cold, humid air was helpful, and the symptoms subsided spontaneously. Serial chest radiographs, cultures, and routine blood tests showed a viral cause, an acute croup. Although the patient's condition was better with medical care (treatment with amoxicillin-clavulanate, systemic steroids, and humidified air), the pediatricians asked the ear, nose, and throat service for further evaluation, because the case involved recurrent croup. Flexible direct laryngoscopy, and rigid bronchoscopy were performed. The patient's vocal folds were normal, and only mucus and some white, friable, mucouslike membranes were found in the upper trachea. The diagnosis of subglottic laryngitis was made, and the subsequent clinical course was excellent. The results of flexible direct laryngoscopy were normal.
Bartolomé M, Cervera J, Mardones G, Valdeón F, Molina E. Imaging Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2001;127(4):453. doi:10.1001/archotol.127.4.453