Subglottic Stenosis in a 3-Year-Old Child Following Prolonged Intubation - A Case Report

Abstract

Subglottic stenosis is a serious complication of prolonged intubation in pediatric patients and Over 90% of acquired cases are iatrogenically caused and result from endotracheal intubation. Subglottic stenosis is an unanticipated problem that needs to be diagnosed and treated immediately. The majority of pediatric subglottic stenosis occurrences are mild to moderate. This case highlights the challenges and outcomes associated with this condition. Here, we present a 3-year-old child presented with high fever and scrotal pain with swelling, diagnosed as scrotal cellulitis. Laboratory results showed anemia, leukocytosis, and metabolic acidosis, and the child's condition deteriorated due to respiratory distress, requiring intubation and PICU admission. Following a scrotal abscess drainage, the child was discharged but returned with severe respiratory distress, cyanosis, and subglottic stenosis, confirmed by laryngobronchoscopy and imaging. After failed extubation attempts and further complications, a tracheostomy and endoscopic subglottic dilation were performed. The child was successfully decannulated after eight days, with near-complete recovery except for a slight change in voice tone. The case highlights the challenges in managing complex respiratory complications in pediatric patients. This case underscores the importance of monitoring for subglottic stenosis in children who have undergone prolonged intubation and demonstrates the efficacy of endoscopic dilatation in managing this complication.