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Virtual Pediatric Hospital: ElectricAirway: Upper Airway Problems in Children ElectricAirway: Upper Airway Problems in Children: Croup Syndromes

Answer to 19

Donna M. Santer, M.D., Michael P. D'Alessandro, M.D.
Peer Review Status: Externally Peer Reviewed by Lauren D Holinger, MD, Robert J. Winter, MD and the AMA
The answer is C. This child has a classic presentation for tracheo/laryngomalacia. These children generally present in the neonatal period, but occasionally they may not present until 2-3 months of age. They have noisy respirations, and expiratory stridor is usually present from birth. More affected children will have hoarseness, aphonia, and inspiratory retractions that are severe enough to cause chest wall deformity. These infants obviously have a difficult time coordinating breathing and feeding, and thus they have poor weight gain. Rhonchi can also be heard on auscultation, but rales are not.

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