Breathing Difficulties III

Question 1

What is bacterial tracheitis otherwise known as?

Answer 1

Bacterial tracheitis is also known as Pseudomembranous croup

Question 2

How different is bacterial tracheitis from croup?

Answer 2

The child looks severely unwell and has a high fever with rapidly progressive airway obstruction by copious thickening of airway secretions.

Question 3

What is the cause of Pseudomembranous croup?

Answer 3

Staphylococcus Aureus

Question 4

What is the cause of croup?

Answer 4

Parainfluenza virus

Other causes include Human Metapneumovirus, Influenza and RSV

Question 5

What are the differential diagnosis for croup?

Answer 5

Epiglottitis, Bacterial Tracheitis/ Pseudomembranous croup, Upper airway foreign body, retropharyngeal abscess, tonsillar abscess, angioneurotic oedema, allergic reaction.

Question 6

What is the treatment of croup?

Answer 6

Usually self-limiting, but can give a single dose of Dexamethasone PO.

If severe croup, hospital admission with Oral Dexamethasone/Prednisolone and nebulised Budesonide.

Give nebulised adrenaline in addition to the above if required. Effects of nebulised adrenaline last for 2-3 hours.

Question 7

What questions are asked in the family and social history for someone suspected with asthma?

Answer 7

Any family history of atopy - eczema, hay fever, asthma?
Does anybody smoke in the house?
Any pets at home?

Question 8

If bronchiolitis is suspected, what investigations are done?

Answer 8

A nasopharyngeal aspirate or swab for RSV immunofluorescence