An unusual presentation of stridor in an infant

A 9-month-old boy presented with a 1-day history of fever and croupy cough. He had been diagnosed with laryngomalacia at 4 months of age and treated for recurrent croup and bronchiolitis. He was <0.4th centile for weight. He had marked biphasic stridor in all positions along with tachypnoea. He showed some initial improvement with bronchodilators, steroids and antibiotics for suspected pneumonia, but his …