A rare reason for recurrent pulmonary infections in infants

A seven month old male presented for the first time at our pulmonary outpatient clinic because of frequent pulmonary infections and recurrent stridor. The parents also reported swallowing difficulties. History revealed postpartum, congenital cardiac defect (ASD, VSD), hypospadia and hydronephrosis, but genetic analysis only showed a heterocygous mutation with inconclusive relevance. Previously, intermittent pulmonary retractions and tachypnea were observed directly after birth, and the patient experienced recurrent pulmonary infections with multiple hospitalizations from the age of one month. We started diagnostic procedure and found patchy consolidations on both sides in x-ray, suspicious for aspiration events. Subsequent videokinematography revealed delayed triggering of swallowing with intradeglutitive aspiration. Following this result, we admitted the patient to our hospital, nasogastric tube was placed, and further workup was started. Computertomography of the chest confirmed patchy consolidations in both lower lobes, and postinflammatory fibrotic residuals, but no other pathologies, except a bronchus suis. Bronchoscopy with laryngoscopy finally showed laryngeal cleft. No other pathologies were found. The patient was then transferred to the ENT department for surgical correction of the defect. Laryngeal cleft is a rare congenital malformation characterized by an abnormal communication between the larynx and the esophagus or trachea, resulting from incomplete fusion of the posterior laryngotracheal wall during embryogenesis. The estimated prevalence is 1:10000–1:20000 live births, though the true incidence is likely underestimated due to diagnostic challenges and variable clinical presentation. Laryngeal clefts may occur in isolation or in association with other congenital anomalies or syndroms and emerging evidence suggests a possible genetic contribution. Recognition and appropriate management of congenital stridor are critical to prevent significant morbidity related to chronic aspiration and respiratory compromise. Publication History Article published online: 26 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany