A Rare Presentation of Acquired Laryngomalacia and Tracheomalacia in a Child Associated with Apricot Sulfurization

Abstract

Sulfur fumigation has come to replace traditional sun drying methods for drying fruits over the years around the world as it is a cheaper and faster method because of its pesticidal and anti-bacterial properties. We report the case of an 11-year-old boy with acquired severe biphasic stridor who was exposed to extremely high concentrations of sulfur dioxide (SO2) during apricot sulfurization processes with his mother. The patient's bronchoscopy revealed severe glottic and subglottic damage. Exposure to SO2 is a health risk, particularly for individuals who are sulfide-sensitive, especially in childhood. The pulmonary epithelium may be directly injured by inhaled toxic substances at various levels of the respiratory system. To the best of our knowledge, this is the first case reported of acquired airway damage associated with sulfurization in a pediatric patient without a known history of any respiratory disease or symptoms.

Keywords: Sulfur dioxide; laryngomalacia; pediatric otolaryngology; pediatrics; tracheomalacia; tracheotomy.

Figure 1

Chest X-ray showing a long segment of stenosis in the trachea

Figure 2. a–d

(a, b) Severe edema and bullous lesions in epiglottis, vocal cords and subglottic area. (c, d) Close to normal appearance on epiglottis and vocal cords after 6 months