Airway Obstruction in Children with COVID-19 Presenting with Stridor
Silpa K Bharathan, Viresh S Swami, Laxman H Bidari
Citation Information :
Bharathan SK, Swami VS, Bidari LH. Airway Obstruction in Children with COVID-19 Presenting with Stridor. Pediatr Inf Dis 2022; 4 (2):62-64.
We report three cases who presented with symptoms of upper airway obstruction that were secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. These children showed no signs of lung parenchymal involvement initially. Our first patient presented with stridor with significant upper airway obstruction and respiratory failure and required emergency intubation followed by tracheostomy. The second child presenting as croup had only partial response to dexamethasone and adrenaline. The third child, who had presented with airway obstruction turned out to have a retropharyngeal collection, was found to be infected with SARS-CoV-2 on RT-PCR from a nasopharyngeal swab. Our cases represent the new presentation of coronavirus disease 2019 (COVID-19) in pediatric patients.
Al-Mutairi B, Kirk V. Bacterial tracheitis in children: approach to diagnosis and treatment. Paediatr Child Health 2004;9(1):25–30. DOI: 10.1093/pch/9.1.25
Zhu N, Zhang D, Wang W, et al. China novel coronavirus investigating and research team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382(8):727–733. DOI: 10.1056/NEJMoa2001017
Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579(7798):270–273. DOI: 10.1038/s41586-020-2012-7
Lu X, Zhang L, Du H, et al. Chinese pediatric novel coronavirus study team. SARS-CoV-2 infection in children. N Engl J Med 2020;382(17):1663–1665. DOI: 10.1056/NEJMc2005073
Parri N, Lenge M, Buonsenso D. Coronavirus infection in pediatric emergency departments (CONFIDENCE) research group. Children with Covid-19 in pediatric emergency departments in Italy. N Engl J Med. 2020;383(2):187–190. DOI: 10.1056/NEJMc2007617
Tsao HS, Chason HM, Fearon DM. Immune thrombocytopenia (ITP) in a pediatric patient positive for SARS-CoV-2. Pediatrics. 2020;146(2):e20201419. DOI: 10.1542/peds.2020-1419
Abdel-Mannan O, Eyre M, Löbel U, et al. Neurologic and radiographic findings associated with COVID-19 infection in children. JAMA Neurol. 2020;77(11):1–6. DOI: 10.1001/jamaneurol.2020.2687Epub ahead of print. Erratum in: 10.1001/jamaneurol.2020.3946
Harless L, Jiang N, Schneider F, et al. Herpes simplex virus laryngitis presenting as airway obstruction: a case report and literature review. Ann Otol Rhinol Laryngol 2017;126(5):424–428. DOI: 10.1177/0003489417699421
Dominguez LM, Simpson CB. Viral laryngitis: a mimic and a monster - range, presentation, management. Curr Opin Otolaryngol Head Neck Surg 2015;23(6):454–458. DOI: 10.1097/MOO.0000000000000203
Tebruegge M, Connell T, Kong K, et al. Necrotizing epiglottitis in an infant: an unusual first presentation of human immunodeficiency virus infection. Pediatr Infect Dis J 2009;28(2):164–166. DOI: 10.1097/INF.0b013e318187a869
vander Hoek L, Sure K, Ihorst G, et al. Croup is associated with the novel coronavirus NL63. PLoS Med 2005;2(8):e240. DOI: 10.1371/journal.pmed.0020240
Pitstick CE, Rodriguez KM, Smith AC, et al. A curious case of croup: laryngotracheitis caused by COVID-19. Pediatrics. 2021;147(1):e2020012179. DOI: 10.1542/peds.2020-012179
Venn AMR, Schmidt JM, Mullan PC. A case series of pediatric croup with COVID-19. Am J Emerg Med 2021;43:287.e1–287.e3. DOI: 10.1016/j.ajem.2020.09.034
Tran K, Cimon K, Severn M, et al. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One 2012;7(4):e35797. DOI: 10.1371/journal.pone.0035797
Ahmed N, Hare GM, Merkley J, et al. Open tracheostomy in a suspect severe acute respiratory syndrome (SARS) patient: brief technical communication. Can J Surg 2005;48(1):68–71.
Ho OY, Lam HC, Woo JK, et al. Tracheostomy during SARS. J Otolaryngol 2004;33(6):393–396. DOI: 10.2310/7070.2004.00393
Morgan P. Tracheostomy in a patient with SARS. Br J Anaesth 2004;92(6):905–906. author reply 906 10.1093/bja/aeh568. DOI: 10.1093/bja/aeh568
