| The patient initially presented at age 13 months to the paediatric department at another hospital with fever, drooling, toxicity and stridor. |
| On examination, she was noted to be sitting upright and breathing without tachypnea, retractions or stridor. |
| Cough, hoarseness, stridor, and wheezing may occur because of disintegration of the airway cartilages. |
| Later, the child appears acutely ill with fever, upper airway compromise, stridor, drooling and respiratory distress. |
| On physical examination, the patient had no stridor, respiratory distress, or cervical lymphadenopathy. |
| They have noisy respirations, and expiratory stridor is usually present from birth. |
