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[Stridor in infants: sometimes not so innocent]
J De Koster1, F De Zegher, H Devlieger
1Dienst Kindergeneeskunde, Universitair Ziekenhuis Gasthuisberg, K.U. Leuven, België.
Insights
Neonatal stridor often indicates a simple viral infection, requiring no specific therapy. However, persistent or severe stridor may signal an underlying anatomic anomaly requiring prompt diagnosis and management.
Area of Science:
- Pediatrics
- Neonatology
- Otolaryngology
Background:
- Stridor is a common respiratory symptom in neonates.
- It can be transient, often associated with viral infections, or indicative of underlying issues.
Observation:
- Discrete inspiratory stridor in alert infants is typically benign.
- Stridor occurring early in life, persisting, or present during expiration warrants further investigation.
Findings:
- An underlying anatomic anomaly is frequently associated with severe, chronic, or expiratory stridor.
- Diagnostic steps include thorough history, physical examination, airway X-rays, and potentially laryngo/bronchoscopy or advanced imaging.
Implications:
- Accurate diagnosis is crucial for initiating appropriate therapeutic management.
- Early identification of anatomic anomalies can prevent complications and improve outcomes.
Abstract:
Stridor is a frequent symptom in the neonate. Often it consists of a discrete inspiratory stridor in an alert child or of a transient symptom of a viral respiratory infection. In both cases no specific therapy is required. Whenever stridor occurs in the first months of life, or when it is severe or chronic, or when stridor also persists throughout expiration, an underlying anatomic anomaly frequently exists. The following steps are important to the diagnostic management: besides a detailed and complete history and physical examination, an X-ray of the airways and, if necessary, laryngo/bronchoscopy, angio(cardio)graphy or computerized tomography of the chest and the cervical region. Subsequently, appropriate therapeutic management can be initiated by proficient and accomplished physicians.