If a 5–year-old child suddenly develops stridor, which one of the following would be the most likely diagnosis –
**Core Concept**
Stridor in a child is a high-pitched sound heard during inhalation, indicating partial airway obstruction. The sudden onset of stridor in a 5-year-old child suggests an acute cause, which can be due to various factors such as foreign body aspiration, acute laryngo-tracheobronchitis, or epiglottitis.
**Why the Correct Answer is Right**
Foreign body aspiration is the most likely diagnosis in this scenario due to the sudden onset of stridor in a child. This occurs when an object enters the airway, causing partial obstruction. The object can be food, a toy, or any other small item that the child could have accidentally inhaled. The stridor heard during inhalation is due to the partial obstruction of the airway by the foreign body, which causes turbulence in the airflow and produces the characteristic high-pitched sound. The child may also exhibit symptoms such as coughing, wheezing, or difficulty breathing.
**Why Each Wrong Option is Incorrect**
**Option A:** Laryngomalacia is a condition characterized by the softening of the tissues of the larynx, which can cause partial airway obstruction. However, it typically presents in the first few weeks of life and is not associated with a sudden onset of stridor in a 5-year-old child.
**Option B:** Acute laryngo-tracheobronchitis, also known as croup, is a viral infection that causes inflammation of the larynx and trachea. While it can cause stridor, it typically presents with a barking cough and hoarseness, rather than a sudden onset of stridor.
**Option D:** Acute epiglottitis is a medical emergency that causes inflammation of the epiglottis, which can lead to airway obstruction. However, it typically presents with a high fever, difficulty swallowing, and drooling, rather than sudden onset of stridor.
**Clinical Pearl / High-Yield Fact**
In pediatric patients, a sudden onset of stridor is often due to a foreign body aspiration, and it is essential to investigate for this possibility promptly to avoid airway compromise.
**✓ Correct Answer: C. Foreign body aspiration**