Congenital long segment tracheal stenosis presenting with tachypnea

An infant born at full term presented with tachypnea, tachycardia and fatigue with feedings. Blood gases revealed hypoventilation. A rigid bronchoscopy using the Karl-Storz telescopic system revealed severe tracheal stenosis. Follow-up three-dimensional computerized tomography scans of the neck and chest revealed a long segment, funnel-shaped tracheal stenosis extending up to the left bronchial orifice. The patient underwent tracheal reconstruction, but died three weeks later from postoperative complications. It is unusual for severe tracheal stenosis to present without stridor, apnea, cyanosis and wheezing. Infants with unexplained tachypnea should be worked-up for congenital deformities of the upper airways.