Differential Diagnosis for Sudden Labored Breathing in a 4-Year-Old with Upper Airway Involvement

• Single Most Likely Diagnosis
  • Croup: This is a common condition in young children characterized by a barking cough and labored breathing, often due to a viral infection. The sudden onset and upper airway involvement make croup a highly plausible diagnosis.
• Other Likely Diagnoses
  • Epiglottitis: Although less common than croup, epiglottitis is an infection of the epiglottis that can cause severe respiratory distress. It's more likely to present with sudden onset and can be life-threatening.
  • Foreign Body Aspiration: Young children are prone to putting objects in their mouths, which can lead to aspiration. This can cause sudden labored breathing if the object obstructs the upper airway.
  • Laryngitis: Inflammation of the larynx can cause hoarseness and labored breathing. It might not be as sudden in onset as croup but can still present acutely.
• Do Not Miss Diagnoses
  • Anaphylaxis: Although rare, anaphylaxis can cause sudden onset of labored breathing due to upper airway edema. It's a life-threatening condition that requires immediate recognition and treatment.
  • Retropharyngeal Abscess: This is a serious infection in the tissues at the back of the throat. It can cause labored breathing and is a medical emergency.
• Rare Diagnoses
  • Angioedema: A rare condition that can cause swelling of the upper airway, leading to labored breathing. It can be hereditary or acquired.
  • Subglottic Stenosis: A narrowing of the airway below the vocal cords, which can be congenital or acquired. It might present with gradual onset of symptoms but can acutely worsen.
  • Laryngeal Papillomatosis: A rare condition caused by the human papillomavirus, leading to growths on the larynx that can obstruct the airway.