THE PATIENT was a full-term female infant born to a mother with genital condylomas. The infant had a hoarse cry from birth. At 5 months of age, she was brought to the emergency department with respiratory distress and aphonia. Her condition was diagnosed and she was treated for a pertussis-like illness. At 6 months of age, she returned with respiratory distress and stridor. She required intubation. Multiple nodular lesions in the subglottic area were resected by laser. The gross and microscopic appearances are shown in Figure 1, Figure 2, and Figure 3.The lesions were recurrent. She required a tracheostomy at 10 months of age to maintain airway patency. The lesions had spread to her bronchi and lungs. She undergoes laryngoscopy and excision of the lesions every 2 to 3 weeks. There are multicavitary cystic lesions in the lungs bilaterally as seen on the computed tomographic scan (Figure 4).
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