Diagnostic red herring in an infant with stridor

Area of Science:

• Pediatric Otolaryngology
• Pediatric Radiology
• Pediatric Airway Management

Background:

• Foreign body aspiration is a common pediatric emergency.
• Laryngeal foreign bodies can present with diverse and sometimes misleading symptoms.
• Accurate diagnosis is essential for timely intervention and preventing complications.

Observation:

• A case of an infant with a laryngeal foreign body is presented.
• The clinical and radiological presentation mimicked a laryngeal web.
• Diagnosis was delayed due to the subtle nature of the findings on imaging.

Findings:

• Radiographic studies demonstrated limited sensitivity in identifying the laryngeal foreign body.
• Endoscopy confirmed the presence of a foreign body in the larynx.
• This case highlights the challenges in diagnosing subtle airway foreign bodies.

Implications:

• Emphasizes the need for high clinical suspicion for foreign body aspiration in infants presenting with airway symptoms.
• Suggests that endoscopy remains the gold standard for diagnosing laryngeal foreign bodies when clinical suspicion is high.
• Highlights the limitations of conventional imaging in detecting certain types of laryngeal foreign bodies.