An Unusual Cause of Recurrent Respiratory Distress

One and a half years old boy presented with recurrent episodes of respiratory distress, accompanied by dry non spasmodic cough and characterized by appearance of a continuous stridor showing no positional variation. the child was symptomatic since early infancy. parents also complained of inability to gain weight as compared to other siblings. there was no history of foreign body ingestion or complaints of asthma or tuberculosis in the family. general physical examination revealed tachypnea and biphasic stridor in a malnourished and stunted child in the absence of any significant lymphadenopathy or oral thrush.