Spasmodic Croup Presenting with Persistent Hiccups: A Case Report

<p>Background: Croup is a common pediatric respiratory illness characterized by a barking cough, inspiratory stridor, and hoarseness resulting from upper airway narrowing. While most cases are of viral etiology, spasmodic croup can be triggered by non-infectious factors such as allergy, gastroesophageal reflux disease, or psychological stress.<br />Case Presentation: We describe a previously healthy with no significant past medical history 10-year-old girl, with multiple presentations to the emergency department with persistent hiccups accompanied by inspiratory stridor with the classic “steeple sign”. Her clinical course suggested overlapping mechanisms, including reflux-related and stress-related functional triggers, as her symptoms improved with proton-pump inhibition and corticosteroids. <br />Conclusion: This case illustrates an unusual presentation of recurrent spasmodic croup with persistent hiccups, likely multifactorial in origin. Awareness of atypical features may help in early identification and improve patient outcomes.</p>