Table 1Differential diagnosis in a child presenting with an airway or severe breathing problem

Diagnosis or underlying causeIn favour
Pneumonia
–

Cough with fast breathing and fever

–

Grunting or difficulty in breathing

–

Development over days, getting worse

–

Crepitations on auscultation

–

Signs of consolidation or effusion

Asthma
–

History of recurrent wheezing

–

Prolonged expiration

–

Wheezing or reduced air entry

–

Response to bronchodilators

Foreign body aspiration
–

History of sudden choking

–

Sudden onset of stridor or respiratory distress

–

Focal reduced air entry or wheeze

Retropharyngeal abscess
–

Slow development over days, getting worse

–

Inability to swallow

–

High fever

Croup
–

Barking cough

–

Hoarse voice

–

Associated with upper respiratory tract infection

–

Stridor on inspiration

–

Signs of respiratory distress

Diphtheria
–

‘Bull neck’ appearance due to enlarged lymph nodes

–

Signs of airway obstruction with stridor and recession

–

Grey pharyngeal membrane

–

No DPT vaccination

From: 1, Triage and emergency conditions

Cover of Pocket Book of Hospital Care for Children
Pocket Book of Hospital Care for Children: Guidelines for the Management of Common Childhood Illnesses. 2nd edition.
Copyright © World Health Organization 2013.

All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: tni.ohw@sredrokoob). Requests for permission to reproduce or translate WHO publications – whether for sale or for non-commercial distribution – should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/copyright_form/en/index.html).

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.