An infant after birth is noticed to have stridor and a hoarse cry. All of the following diagnosis are possible except:
**Core Concept:**
Stridor is a high-pitched, wheezing, or whistling sound heard during breathing, typically in the neck or upper airway. A hoarse cry is a change in the infant's voice quality, often described as raspy or harsh. These symptoms may indicate a respiratory issue in the newborn.
**Why the Correct Answer is Right:**
Infants experiencing stridor and a hoarse cry are often suffering from laryngomalacia, a condition where the soft palate and arytenoid cartilages collapse the larynx, leading to airway obstruction. The correct answer (C) is "cyanosis," as it is less likely to present as a primary symptom in this context. Cyanosis itself is a sign of severe respiratory distress or circulatory compromise, not a primary cause of stridor and hoarse cry.
**Why Each Wrong Option is Incorrect:**
A. "Fever" is not a specific cause of stridor and hoarse cry in an infant. While fever might exacerbate symptoms or be a contributing factor, it is not the primary diagnosis.
B. "Respiratory distress" is not a specific diagnosis but a general term for breathing difficulties in infants. While respiratory distress might be present, it does not explain the specific symptoms of stridor and hoarse cry.
D. "Asthma" is a common respiratory condition in older children and adults but is less likely in infants due to their immature immune systems and respiratory muscle development. Asthma would typically present with coughing, wheezing, and hypoxia, not stridor and hoarse cry.
**Clinical Pearl:**
Infants experiencing stridor and hoarse cry should be evaluated for laryngomalacia, which is a common cause of stridor in infants and does not typically coexist with cyanosis. Fever, respiratory distress, and asthma are less likely primary causes, while cyanosis is a secondary sign rather than a primary diagnosis.