Critical airway obstruction associated with extensive subglottic inflammatory slough and oedema following severe acute respiratory syndrome SARS-CoV-2 infection in a child.
Yoichiro Ota, Yusuke Ito, Kazuhiro Omura
✦ AI-curated · Sources linked
Case in brief
A child with SARS-CoV-2 infection presented with critical airway obstruction due to severe subglottic edema and inflammatory slough. Airway assessment revealed significant narrowing, and despite initial nebulized epinephrine treatment, the patient experienced hypoxemia and loss of consciousness. Surgical intervention involved the removal of obstructive slough, and an undersized endotracheal tube was used due to persistent edema. The patient was discharged on day 10 without complications.
What made this case unusual
The case is notable for the requirement of a markedly undersized endotracheal tube (internal diameter 4.5 mm) due to severe subglottic edema following SARS-CoV-2 infection.
Diagnostic / clinical pearl
Clinicians should be aware that severe subglottic edema can occur in children post-SARS-CoV-2 infection, necessitating careful airway management and potential use of undersized intubation equipment.
Why it matters
This case underscores the critical need for definitive airway management in pediatric patients with severe respiratory complications following COVID-19.