Non-asthma airway problems

Abstract 

Respiratory infections in the airway are extremely common in young children. Croup is a viral infection of the larynx and trachea, and presents with a barking cough and stridor usually in children aged one to two years. Bronchiolitis is a viral infection resulting in coughing, wheezing and tachypnoea. It is an illness of infancy occurring in epidemics in the winter months. Hospital admission is often required and treatment is supportive with oxygen, nasogastric feeding or intravenous fluids. There is an association between bronchiolitis in infancy and asthma in school age. Stridor presenting shortly after birth is usually secondary to laryngomalacia and is a benign condition, the stridor gradually improving over a period of months. Fixed obstruction of the airway is uncommon but is seen most-often in ex-preterm infants who develop subglottic stenosis as a result of scarring from endotracheal intubation. Children with neurological or neuromuscular abnormalities may have upper airway obstruction from vocal cord dysfunction. Foreign body inhalation must always be considered as a possible diagnosis if a child presents with sudden onset wheeze or stridor. Bronchiectasis in the absence of a diagnosis of cystic fibrosis is uncommon although primary ciliary dyskinesia is seen with increasing frequency in Asian children. Extremely preterm infants commonly develop chronic airway problems with significant symptoms, which usually improve with age.

Keywords: bronchiectasis, bronchiolitis, bronchopulmonary dysplasia, croup, laryngomalacia, subglottic stenosis, tracheomalacia