Respiratory Medicine Case Reports (Jan 2020)

Pediatric airway compromise due to thyroid storm associated with influenza A infection: A case report

  • Taiki Higaki,
  • Kohei Tsukahara,
  • Takafumi Obara,
  • Tsuyoshi Nojima,
  • Hirotsugu Yamamoto,
  • Takaaki Osako,
  • Hiromichi Naito,
  • Atsunori Nakao

Journal volume & issue
Vol. 31
p. 101182

Abstract

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Thyroid storm is a potentially fatal intensification of thyrotoxicosis normally marked by tachycardia, hyperthermia, impaired mental status, and severe agitation. It can be initiated by numerous causes. Failure to promptly diagnose the condition may lead to high mortality. Early diagnosis and treatment of thyroid storm are essential to prevent further life-threatening complications. A 10-year-old girl was admitted to our emergency center for intensive care. The patient presented tachypnea with stridor, paradoxical abdominal breathing, and “barking” cough. The patient was diagnosed as upper airway obstruction complicated by thyroid storm associated with influenza infection. Following immediate airway management, the patient was administered a short-acting beta-blocker, hydrocortisone, thiamazole, and saturated solution of potassium iodide was initiated. The patient was extubated on day 8 and transferred to a local hospital on day 11 without adverse complications. When examining patients with influenza infection, emergency doctors should be more attentive not to miss other critical diagnoses. The present case was initially diagnosed as croup due to influenza infection. Sharing our experience may help emergency physicians treat similar cases of pediatric airway compromise due to thyroid storm.

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