A Case of Life‐Threatening Stridor: Vallecular Cyst in a 2‐Month‐Old Infant

TL;DR

A 2-month-old infant with a rare vallecular cyst causing severe breathing issues was successfully treated with surgery and targeted antibiotics.

Contribution

Highlights the diagnostic challenges and management of vallecular cysts in infants with limited resources.

Findings

Vallecular cysts can cause severe respiratory distress and require urgent intervention.

Postoperative infections with XDR Acinetobacter can be managed using targeted antibiotic therapy.

Abstract

Vallecular cysts are uncommon birth defects that substantially restrict an infant's airway. This paper emphasizes the difficulties in diagnosing and managing a transfer case with limited resources. If these cysts are not detected early, they can have major clinical consequences. A 2‐month‐old female infant presented with progressive inspiratory stridor, respiratory distress, vomiting, and fever over one month. Initial investigations suggested pneumonia, but direct laryngoscopy revealed a large vallecular cyst compressing the laryngeal structures. Blood cultures grew
Staphylococcus epidermidis
(MRSE). Emergency tracheostomy preceded complete cyst excision. Postoperative tracheal cultures identified XDR Acinetobacter, managed with targeted antibiotics.

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