Stridor and Inspiratory Wheezing

MANUAL OF CLINICAL DIAGNOSIS

Stridor and inspiratory wheezing are abnormal respiratory sounds occurring during inspiration, typically indicating an obstruction in the upper airways. Stridor is a high-pitched, harsh sound mainly heard in the laryngeal or tracheal region, while inspiratory wheezing is a high-pitched, continuous sound caused by turbulent airflow through narrowed airways. These clinical manifestations can be signs of conditions ranging from acute infections to mechanical obstructions or severe allergic reactions.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Epiglottitis	High fever, dysphagia, drooling, muffled voice, stridor, tripod posture	Medical history, physical examination, signs of respiratory obstruction	Lateral neck X-ray, laryngoscopy, blood cultures
Croup	Barking cough, stridor, hoarseness, mild fever, worsening at night	Medical history, physical examination, signs of respiratory obstruction	Neck X-ray (steeple sign), oximetry
Foreign Body Inhalation	Sudden onset of coughing, stridor, wheezing, choking, cyanosis	History of aspiration, physical examination, unilateral decreased breath sounds	Chest X-ray, bronchoscopy
Laryngomalacia	Intermittent inspiratory stridor, worsening in supine position, absence of other infection signs	Medical history, physical examination, signs of respiratory obstruction	Flexible laryngoscopy, videolaryngoscopy
Laryngeal Papillomas	Hoarseness, stridor, chronic cough, difficulty breathing	Medical history, physical examination, signs of respiratory obstruction	Laryngoscopy, laryngeal biopsy
Anaphylaxis Causing Laryngeal Oedema	Sudden onset of dyspnoea, stridor, urticaria, hypotension, wheezing, angioedema	History of allergen exposure, physical examination, signs of anaphylactic shock	Allergy tests, blood tryptase levels