Recurrent respiratory papillomatosis in a 5-year old child from sokoto, Nigeria: A masquerader of childhood bronchial asthma

Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease caused by the human papilloma virus. A delay in appropriate intervention could be caused by the symptomatology being similar to bronchial asthma.A 5-year-old boy presented to the pediatric emergency unit of Usmanu Danfodiyo University Teaching Hospital with a 2-year history of recurrent difficulty in breathing, cough and noisy breathing. He had previously received several treatments for asthma at Primary Health Care (PHC) facilities. On examination, he was dyspneic with a respiratory rate of 60 cycles/minute, oxygen saturation was 86% on room air, and chest auscultation showed vesicular breath sounds. Initially, acute severe asthma was diagnosed. However, further examination revealed wart-like lesions protruding below the pharynx, and a diagnosis of respiratory papillomatosis was considered. He had an emergency tracheostomy and video-assisted laryngoscopy with excision of the lesions. The histological report confirmed a laryngeal papilloma. His clinical condition improved after removal of wart-like lesions, and he was discharged afterwards. He had three relapses and surgical removal (September and December 2023, June 2024). Currently, he is stable and is being followed up at the Pediatric and Otorhinolaryngology Clinic.