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Juvenile rheumatoid arthritis (JRA), now termed juvenile idiopathic arthritis (JIA), is a well-described group of arthritides in the pediatric population with known associations with airway compromise. Subclasses are based on associated symptoms and number of joints involved, namely pauciarticular, polyarticular, and systemic onset JRA. Cricoarytenoid arthritis (CA), as a cause of airway compromise, is rarely associated with JRA as compared to adult onset rheumatoid arthritis, however, there are reports of CA with JRA. Additionally, JRA is associated with other rheumatologic diseases, which include a reported case of Wegener's granulomatosis. Wegener's granulomatosis has a well-established association with subglottic stenosis. Described below is the case study of an 18 year-old African American female with a 5-year history of pauciarticular juvenile rheumatoid arthritis developed worsening shortness of breath, orthopnea, and stridor over a 1-month period. The patient had a firm circumferential subglottic mass obstructing approximately 80% of the lumen and requiring tracheostomy tube placement. Biopsies of the mass revealed only acute and chronic inflammation. There was no evidence of rheumatoid nodules, granulomas, acid fast, or fungal organisms. To our knowledge, this is the first case history reported of a patient with JRA and idiopathic subglottic stenosis; this potentially establishes an association between the two disease processes.

Since the early 2000s, studies have shown that the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections in the pediatric population has been increasing. Moreover, studies also have indicated a trend toward increased resistance to commonly used antibiotics over time. However, few studies have specifically focused on such trends in pediatric neck abscesses. We undertook a retrospective study of 109 patients to compare the incidence of pediatric neck abscesses caused by MRSA during two separate 5-year periods at Children's Hospital of New Orleans in an attempt to determine if the incidence was indeed increasing. We also analyzed differences in MRSA susceptibility to various antibiotics over the same two time periods-January 1997 through December 2001 (n = 22) and January 2002 through December 2006 (n = 87). We found a statistically significant increase in the incidence of MRSA between the first 5-year period and the second-from 25 to 70.3% (p = 0.0388). We did not find any significant difference in antibiotic susceptibility patterns between the two 5-year periods.