Recurrent Croup Attack in a Child with Laryngeal Papillomatosis and Review of the Literature

Croup, a common contion and associated with pathological conditions in childhood, may indicate the presence of disease recurrence. Gastroesophageal reflux disease and allergic sensitization in children with recurrent croup are conditions that first come to mind. Hoarseness is a rare symptom in the pediatric age group. In this study we report the case of a three-year-old girl with laryngeal papillomatosis who had suffered from chronic hoarseness since eight months of age and had croup attack four times since one year of age. Laryngeal papillomatosis is the most common benign neoplasm of the larynx among children and the second most frequent cause of childhood hoarseness. After changes in voice, stridor is the second common symptom, first inspiratory and then biphasic. This disease may affect individuals across all age groups and show a diverse clinical course. Chronic cough, recurrent pneumonia, failure to thrive, dyspnea, dysphagia and acute respiratory distress are less common presenting symptoms. These patients are often misdiagnosed as having asthma, croup, allergies, vocal nodules or bronchitis. If there is chronic hoarseness and changing quality of voice in a history of any child presenting with recurrent croup or asthma-like symptoms, referral to an otolaryngologist should be considered with a view to laryngoscopy. (J Pediatr Inf 2013; 7: 170-3)