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The Tale of Stridor and Wheezing in an Infant

Umer Muhammad1, Marcus Shaffer1, John Bishara1

  • 1Women and Children's Hospital, CAMC/West Virginia University-Charleston, Charleston, WV, USA.

Case Reports in Pediatrics
|February 25, 2021
PubMed

Insights

Recurrent respiratory papillomatosis, a HPV-related airway disease, caused severe respiratory distress in an infant. Treatment involved debulking surgery and intralesional bevacizumab for persistent symptoms.

Area of Science:

  • Pediatric Otolaryngology
  • Respiratory Medicine
  • Viral Infections

Background:

  • Recurrent respiratory papillomatosis (RRP) is a rare, HPV-driven condition affecting the aerodigestive tract, primarily the larynx.
  • RRP can lead to significant airway obstruction and respiratory compromise, particularly in infants.

Observation:

  • A 7-month-old male infant presented with severe respiratory distress due to an acute RSV infection.
  • Bronchoscopy revealed extensive papillomatous lesions in the larynx, vocal cords, and trachea.
  • Initial medical management failed to resolve the respiratory failure.

Findings:

  • Emergent debulking surgery was performed to relieve airway obstruction.
  • The infant experienced multiple exacerbations requiring repeated surgical interventions.
  • Intralesional bevacizumab therapy was trialed with limited success.

Implications:

  • This case highlights the challenges in managing severe RRP in infants.
  • Aggressive surgical and medical management may be necessary for RRP control.
  • Further research into novel therapeutic strategies for RRP is warranted.

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