CASE 30 - Child with noisy/strange breathing

Question 1

Can you explain to me exactly what is going on with my child and what can be done for it?

How will I be able to get a ride to the office?

Answer 1

It is hard for me to give you an accurate answer over the phone. I would like you to bring your child here so that I can examine her and perhaps run some tests.

After that, I will be able to give you a more accurate assessment of her condition.

We will arrange for the social worker to speak with you about arranging transportation to the office.

Question 2

Specific Qs:

Answer 2

1. Description of the activity that preceded the event.
2. Description of the sound.
3. Sound always the same?
4. Best heard on inhalation or exhalation?
5. Can you identify anything that may have caused it?
6. Barking in nature?
7. Crying? Muffled/weak?
8. Drooling?
9. Blueness of skin?

Question 3

DDx:

Answer 3

1. Foreign body aspiration.
2. Croup.
3. Epiglottitis.
4. Laryngitis.
5. Retropharyngeal abscess.
6. Angioedema.
7. Peritonsillar abscess.
8. Laryngeal papilloma.

Question 4

Workup:

Answer 4

1. ABG.
2. CXR—PA and lateral.
3. XR—neck, AP and lateral.
4. CBC with differential.
5. Bronchoscopy.
6. Direct laryngoscopy.