Laryngeal papillomatosis presenting as acute airway obstruction in a child

Upper airway obstruction, regardless of cause, can masquerade or be misdiag nosed as lower airway disease in children. In such cases, therapeutic trial s of antibiotics, bronchodilators, and over-the-counter medications for sym ptom relief routinely fail; however, the original diagnosis often goes unch allenged. If the obstructive process is progressive, then acute occlusion o f the airway may occur, rapidly leading to suffocation and death if resusci tation is unsuccessful. Outlined in this report is the case of a young fema le with a history of asthma, poorly responsive to outpatient treatment, who presented with respiratory arrest, The cause of the respiratory collapse w as later identified as a large laryngeal papilloma, a condition rarely enco untered by emergency physicians.