Upper airway obstruction as the presenting manifestation of leukemia

The general clinical features of the acute pediatric leukemias are similar. There is a fairly consistent picture of brief symptoms, which include weakness or fatique, bleeding or bruising, and bone or joint tenderness. Acute or subacute fever also is a common symptom. The fever can result from the underlying malignancy, but is more often the result of an infectious complication. We present a toddler, ultimately diagnosed with acute leukemia, who experienced few of the classic features. He presented as a case of febrile upper airway obstruction.