Presentation
Stridor, fever, non-productive cough, and irritability.
Patient Data
There is distention of the hypopharynx.
There is adenoidal hypertrophy and palatine tonsillar enlargement.
There is hyperinflation with a central trachea and a normal cardiomediastinal contour.
There is smooth, subglottic tracheal narrowing.
There is no aspirated radio-opaque foreign body.
Case Discussion
An example of the tracheal steeple sign 1.2. There is smooth, tapered narrowing of the subglottic trachea caused by mucosal edema, secondary to a viral infection of the upper airway. The narrowed trachea resembles a church steeple. The appearance is also known as the wine bottle sign/pencil tip sign or the inverted V sign 2.
The clinical and radiological differential diagnosis includes:
foreign body aspiration
upper airway abscess formation
angioneurotic edema
tracheal injury/ trauma
congenital airway abnormalities including bronchogenic cysts
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early Guillain-Barre syndrome
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