Presentation
Stridor with an acute onset of a severe "barking" cough, with fever and headache.
Patient Data
There is a smooth, uniform, narrowing of the subglottic airway, well visualised on the AP series.
There is mild distention of the hypopharynx and subtle subglottic tracheal narrowing on the lateral series.
The cervical soft tissues are normal.
There is smooth, subglottic, tracheal narrowing, partially imaged on the chest X-ray.
The chest X-ray is otherwise unremarkable.
Case Discussion
An example of the steeple sign/ wine bottle sign/ inverted V sign/ pencil tip sign 1.2 is due to the smooth tapering of the proximal subglottic trachea in a setting of croup/ acute laryngotracheobronchitis (LTB).
This is best visualised on the AP cervical soft tissue series.
The child presented during a recent bout of a community outbreak of respiratory syncytial virus(RSV).
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