Differential Diagnosis for Stridor in Adults
Single Most Likely Diagnosis
- Laryngitis or Laryngotracheitis: This is often the most common cause of stridor in adults, resulting from inflammation of the larynx or trachea, usually due to viral or bacterial infections. It leads to swelling and narrowing of the airway, causing stridor.
Other Likely Diagnoses
- Foreign Body Aspiration: Although more common in children, adults can also aspirate foreign bodies, especially if they have altered mental status or are under the influence of substances. This can lead to sudden onset of stridor.
- Anaphylaxis: A severe, life-threatening allergic reaction that can cause swelling of the airway, leading to stridor.
- Acute Epiglottitis: Inflammation of the epiglottis, which can be life-threatening if not promptly treated. It's less common than laryngitis but still a significant cause of stridor in adults.
- Vocal Cord Paralysis: Can be unilateral or bilateral, with bilateral paralysis more likely to cause stridor due to the inability of the vocal cords to move apart during inhalation.
Do Not Miss Diagnoses
- Angioedema: A condition characterized by rapid swelling of the dermis, subcutaneous tissue, mucosa, and submucosal tissues. It can cause airway obstruction and is a medical emergency.
- Tumor (Laryngeal or Tracheal): Although less common, tumors in the larynx or trachea can cause stridor by obstructing the airway. Early diagnosis is crucial for treatment and prognosis.
- Retropharyngeal or Peritonsillar Abscess: These infections can spread to the airway, causing obstruction and stridor. They require prompt antibiotic treatment and sometimes surgical drainage.
Rare Diagnoses
- Relapsing Polychondritis: A rare autoimmune disorder that can cause inflammation and destruction of cartilaginous structures, including those in the trachea and larynx, leading to stridor.
- Sarcoidosis: A condition that can affect multiple parts of the body, including the lungs and airways. It can cause granulomatous inflammation that may lead to stridor, although this is rare.
- Tracheal Stenosis: Narrowing of the trachea, which can be congenital or acquired (e.g., due to prolonged intubation). It can cause stridor and is a rare but important diagnosis to consider.