BACKGROUND
A 36-year-old man is referred by his primary care physician because of noisy breathing that is not responding to the asthma treatment. He had difficulty breathing for 2 weeks, and it is becoming progressively worse. The patient was intubated and mechanically ventilated for chest trauma a few months ago. On examination, the patient appears comfortable but has a wheeze resembling stridor during inspiration and expiration. His vital signs are stable. On examination, the larynx is normal. Chest examination reveals generalized transmitted sounds, but findings are otherwise essentially normal. MRI of the upper airway and neck is performed. What is the diagnosis?
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Hint
The patient has a history of intubation.
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Author:
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Prepageran Narayanan, MD, FRCS, and Rahmat Omar, MD, MS
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University Malaya Medical Center, Kuala Lumpur, Malaysia
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Associate Editor:
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R. Raman, MD, MS
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University Malaya Medical Center, Kuala Lumpur, Malaysia
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eMedicine Editor:
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Sat Sharma, MD
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Associate Professor, University of Manitoba, Department of Medicine, Division of Pulmonary Medicine
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eMedicine Case
