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Vocal cord dysfunction presenting as acute asthma in a pediatric patient
M P Poirier1, A M Pancioli, G A DiGiulio
1Division of Emergency Medicine, Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
Pediatric Emergency Care
|June 1, 1996
Summary
Paradoxical vocal cord movement can present as acute wheezing in children. Pediatric emergency physicians should consider this diagnosis, especially when typical asthma symptoms are absent.
Area of Science:
- Pediatric Pulmonology
- Emergency Medicine
- Laryngology
Background:
- Wheezing is a common respiratory symptom in pediatric patients.
- Reactive airway disease is the most frequent cause of wheezing.
- Vocal cord dysfunction (VCD) can mimic other respiratory conditions.
Observation:
- A pediatric patient presented with acute onset wheezing as the initial symptom.
- Physical examination suggested vocal cord dysfunction.
- Flexible fiberoptic nasopharyngoscopy confirmed the diagnosis of paradoxical vocal cord movement.
Findings:
- This case represents the first report of paradoxical vocal cord movement presenting as the initial episode of wheezing in the emergency department.
- The diagnosis of vocal cord dysfunction is feasible in the pediatric population.
- Paradoxical vocal cord movement can manifest as new-onset wheezing.
Implications:
- Pediatric emergency physicians should include paradoxical vocal cord dysfunction in the differential diagnosis for pediatric wheezing.
- Consider VCD in children with wheezing who lack typical features of reactive airway disease.
- Early diagnosis of VCD can lead to appropriate management and prevent unnecessary treatments for asthma.