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Recurrent croup in a young child: look beyond airways disease

Saurav Jain1, Taruna Yadav2, Prawin Kumar3

  • 1Pediatrics, All India Institute of Medical Sciences, Jodhpur, India.

BMJ Case Reports
|February 23, 2021
PubMed

Insights

A rare case of unilateral absent pulmonary artery (PA) in a child presenting with recurrent croup was identified. This condition, causing lung hypoplasia, requires clinical suspicion in pediatric patients with similar symptoms.

Area of Science:

  • Pediatric Pulmonology
  • Cardiovascular Imaging
  • Congenital Thoracic Abnormalities

Background:

  • Recurrent croup in infancy can indicate underlying structural abnormalities.
  • Unilateral lung hypoplasia may be associated with vascular anomalies.

Purpose of the Study:

  • To report a rare case of unilateral absent pulmonary artery (PA) in a pediatric patient.
  • To highlight the diagnostic approach and conservative management of this condition.

Main Methods:

  • Clinical examination, chest radiography, flexible bronchoscopy, CT angiography, and echocardiography were utilized.
  • Diagnostic imaging focused on evaluating lung development and pulmonary vasculature.

Main Results:

  • A 5-year-old boy presented with recurrent croup, reduced breath sounds on the right, and mediastinal shift.
  • Imaging revealed a hypoplastic right lung, absent right pulmonary artery, and dilated left pulmonary artery.
  • Bronchoscopy showed tracheomalacia and left bronchomalacia due to external compression.

Conclusions:

  • Unilateral absent pulmonary artery is a rare congenital anomaly.
  • It should be suspected in children with unilateral hypoplastic lung and respiratory symptoms.
  • Conservative management is appropriate in asymptomatic children without pulmonary arterial hypertension.

Keywords:
cardiovascular medicineearnose and throat/otolaryngologypaediatricsradiology

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