Cough differentials Flashcards
Specific features of croup
Seal like barking cough, worse at night
Autumn time
Specific features of whooping cough
Paroxysmal cough
High pitched inspiratory sound after cough
Pathogen for croup vs whooping cough
Croup = parainfluenza virus
Whooping = bordatella pertussis
X ray sign in croup, differentiate this from acute epiglottitis
STEEPLE sign in AP view - subglottic narrowing
Thumb sign in lateral view - swelling of epiglottis
Mx of croup
0.15mg/kg stat dose of oral dex
Emergency - high flow o2, nebulised adrenaline
Epidemiology of croup
6m-6years
M>F
Scoring system for croup
Westley score
Mild - occasional cough
Moderate - frequent cough but happy kid with recessions
Severe - frequent cough, sternal recessions, distress
When do you admit a child with croup?
If moderate or severe or <6m or known upper airway probs like laryngomalacia/downs
What advice would you give the parents of a child with croup?
Good fluid intake
Go to hosp if skin pulling between ribs, pallor, child is distresses/agitated
Complications of croup
Severe upper airway obstruction can rarely lead to respiratory failure and arrest
Intubation may be required in those with impending respiratory failure
Secondary bacterial superinfection
Pulmonary oedema
Pneumothorax
Whooping cough - is it a notifiable disease?
YES
Mx of Bordatella pertussis
Macrolide
If pregnant - erythro
If not pregnant and over 1m - azithro
if <1m - clarithromycin
Advise to finish vaccinations and give prophylactic abx to close contacts
