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Case Reports in Emergency Medicine
Volume 2013 (2013), Article ID 728405, 4 pages
http://dx.doi.org/10.1155/2013/728405
Case Report

Acute Stridor and Respiratory Failure due to Retrosternal Subglottic Stenosis of Unknown Origin

1Intern, Gold Coast Hospital, Southport QLD 4215, Australia
2School of Medicine, Bond University, Gold Coast QLD 4226, Australia
3Department of Emergency Medicine, Gold Coast Hospital, Southport QLD 4215, Australia
4School of Medicine, Griffith University, Gold Coast QLD 4215, Australia
5Intensive Care Unit, Gold Coast Hospital, Southport QLD 4215, Australia
6Haematology Department, Gold Coast Hospital, Southport QLD 4215, Australia
7Anaesthetics Department, Gold Coast Hospital, Southport QLD 4215, Australia

Received 26 March 2013; Accepted 5 July 2013

Academic Editors: H. David and K. Jani

Copyright © 2013 Tharindu Vithanage et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Respiratory failure due to subglottic stenosis is a rare but serious condition. A 22-year-old male presented to the emergency department (ED) with shortness of breath, stridor, and change in tone of voice. The patient did not complain of B-symptoms (fever, weight loss, and night sweats). In the week before this presentation, he was diagnosed with an upper respiratory tract infection with associated bronchospasm and discharged on oral antibiotics and inhaled salbutamol without effect. He developed hypercapnic respiratory failure in the ED after a coughing episode. A normal nasopharyngoscopic examination and a subtle mediastinal abnormality on chest radiograph lead to a working diagnosis of retrosternal subglottic obstruction. The complexities of his airway management and suggestions for multidisciplinary approach are discussed.