Presentation
Acute respiratory distress, barking cough and inspiratory stridor.
Patient Data
Narrowing of the glottic and subglottic regions (giving the steeple sign) by circumferential mucosal thickening encroaching upon its lumen.
Enlarged nasophayrngeal adenoids encroaching upon the nasopharyngeal air column.
Comparison between normal CT virtual bronchoscopy and a CT virtual bronchoscopy for a case of croup.
Narrowing of the glottic and subglottic regions (giving the steeple sign).
Case Discussion
This is a case of a clinically proven croup. Croup, also known as acute laryngotracheobronchitis, is an upper airway infection by parainfluenza virus or respiratory syncytial virus. On imaging, it classically presents with a narrowing of the subglottic airway and ballooning of the hypopharynx. The narrowed subglottic airway (upper trachea) may resemble a church steeple (steeple sign or wine bottle sign) due to its tapered appearance.
Differential diagnosis include:
- tracheal foreign body aspiration
- angioneurotic edema
-
epiglottitis
- enlargement of epiglottis and aryepiglottic folds
- thumb sign (or omega sign)
- usually older children
- enlargement of epiglottis and aryepiglottic folds
- congenital subglottic stenosis: different clinical presentation