Croup

Question 1

What is it?

Answer 1

Viral infection causing laryngotracheobronchitis.

Parainfluenza virus

Question 2

RF

Answer 2

6months to 6 years.

Slight male bias

Question 3

Presentation

Answer 3

Rhinorrhoea, fever, cough thats worse at night. Seal like cough. Hoarse voice.

Exam shows tridor, reduced breath sounds possible resp distress.

Mild – seal-like barking cough but no stridor or sternal/intercostal recession at rest.

Moderate – seal-like barking cough with stridor and sternal recession at rest; no agitation or lethargy.

Severe – seal-like barking cough with stridor and sternal/intercostal recession associated with agitation or lethargy.

Question 4

Investigations

Answer 4

FBC, CRP, UandE
CXR
Pulse oximetry

Question 5

Management

Answer 5

Symptoms remain up to 7 days
Regular nutritional, fluid support and temperature control.
Prescribe single dose of dexamethasone (0.15mg/Kg)

Emergency - nebulised adrenaline.