Chapter 18 viral croup

Question 1

What are some of the features for croup?

Answer 1

Noisy breathing, prodrome of runny nose, sore throat (viral prodrome), vaccinations are up-to-date, low-grade fever, inspiratory stridor

Question 2

What is a differential diagnosis for this patient?

Answer 2

Bacterial croup , epiglottitis, tracheitis, peritonsillar abscess, foreign body ingestion, viral croup

Question 3

What occurs in the other differentials that doesn’t occur in viral croup?

Answer 3

High fevers and more abrupt onset and more severe respiratory symptoms

Question 4

What qualifies a patient and to have moderate to severe croup? What is the treatment for moderate to severe stridor/croup?

Answer 4

Having stridor at rest. Oral steroids and nebulized epinephrine

Question 5

What is the workout for croup?

Answer 5

CBC, neck x-rays, chest x-rays showing steeple sign or subglottic narrowing

Question 6

What is found in CBC and croup?

Answer 6

Elevated white count with predominance of neutrophils or lymphocytes

Question 7

What is considered mild croup? What is the treatment?

Answer 7

Cool humidified mist and oxygen. Oral dexamethasone

Question 8

What is considered Moderate to severe croup and what is the treatment?

Answer 8

Anxious/agitated, retractions, stridor at rest. Add nebulized epinephrine with Mild croup treatment. If no improvement, admit

Question 9

What should be done if bacterial infection is suspected?

Answer 9

Add second generation cephalosporin antibiotics