Differential diagnosis | Evidence for | Evidence against |
---|---|---|
Foreign body aspiration | History of retrieval of pencil. Sudden onset, no prodromal symptoms | No evidence of FB on the radiograph |
Traumatic injury | History of playing with a sharp object | No evidence of injury on ENT examination |
Acute laryngotracheobronchitis | Stridulous breathing, non-toxic, common diagnosis | No response to steroids or adrenaline nebulisers |
Acute epiglottis | Fever albeit low grade, stridulous breathing, drooling | No prodromal symptoms, fever spike only after admission, no improvement to intravenous antibiotics |
Acute asthma | Generalised wheeze, common diagnosis | Only transient improvement to maximum bronchodilators and steroids |
ENT, ear, nose and throat; FB, foreign body.