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Case report
Recurrent croup in a young child: look beyond airways disease
  1. Saurav Jain1,
  2. Taruna Yadav2,
  3. Prawin Kumar1 and
  4. Jagdish Prasad Goyal1
  1. 1Pediatrics, All India Institute of Medical Sciences, Jodhpur, India
  2. 2Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, India
  1. Correspondence to Dr Prawin Kumar; drprawin484{at}gmail.com

Abstract

We reported here a boy aged 5 years who presented for the evaluation of recurrent croup since infancy. On chest examination, breath sounds were reduced throughout the right lung field with a shifting of the trachea and cardiac apex to the right side. The chest radiograph showed a small right lung with decreased vascularity, hyperinflated left lung and mediastinum shifted towards the right side. Flexible bronchoscopy revealed tracheomalacia with left bronchomalacia due to external pulsatile compression. In CT angiogram, the right pulmonary artery (PA) was absent with dilated left PA. Echocardiography did not show any features of pulmonary arterial hypertension (PAH). Since the child was growing well, and there was no limitation of activity and evidence of PAH, he was managed conservatively and kept on follow-up. Though unilateral absent PA is a rare condition, it should be suspected in children with unilateral hypoplastic lung.

  • paediatrics
  • cardiovascular medicine
  • ear
  • nose and throat/otolaryngology
  • radiology

https://doi.org/10.1136/bcr-2020-236605

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    Footnotes

    • Contributors PK and JPG conceptualised the study and designed the manuscript. SJ was involved in data collection and preparation of the initial draft. TY was involved in the acquisition of radiological data, formatting of images and writing the initial draft. All authors were involved in editing and critical review of the manuscript and gave final approval for the submission. PK will act as a guarantor for this manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.