Stridor refers to noisy, crowing respiratory sounds, usually associated with inspiration.

A common example of stridor would be the characteristic sound of breathing during a croup attack. The hallmark barking cough of croup is an exaggerated form of stridor. Another cause of stridor, which is persistent and not part of an acute illness, occurs with the congenital malformation of laryngomalacia or tracheomalacia. Stridor can also be caused by a foreign object lodged in the throat. A very rare cause of stridor is diphtheria.

The most dangerous cause of stridor, thankfully now rare due to universal immunization against Hemophilus influenzae type B (HiB) is bacterial epiglottitis. In this infection, the epiglottis (the flap of tissue that closes off the larynx when one swallows) and the laryngeal tissues around it become greatly swollen and inflamed. The illness is rapidly progressive, and the airway can be completely closed off in a very short time. Unless an airway is established quickly by breathing tube placement or tracheostomy, the child will rapidly suffocate. This disease could be confused with viral croup in its early stages. Symptoms are

  • sudden onset of a peculiar form of muffled hoarseness (the "hot potato voice")
  • stridor
  • high fever
  • drooling because swallowing secretions becomes impossible
  • restlessness, preferring to sit upright and leaning forward (the position of easiest breathing)

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