Croup

Question 1

Virus responsible for croup

Answer 1

Parainfluenza

Question 2

Main characteristic feature of croup

Answer 2

stridor
- due to laryngeal oedema/secretions

Question 3

Peak age of incidence

Answer 3

6 months - 3 years

Question 4

In what season is croup most common?

Answer 4

Autumn

Question 5

Clinical features of croup

Answer 5

stridor
barking cough (worse at night)
fever
coryzal symptoms

Question 6

Features which would indicate SEVERE croup

Answer 6

• Frequent barking cough
• Prominent stridor at rest
• Sternal wall retractions
• Distress/agitation/lethargy/ restlessness
• tachycardia if obstructive

Question 7

Patients with moderate to severe croup are usually admitted. What other features may prompt admission

Answer 7

< 6 months

known airway abnormalities
(e.g. Laryngomalacia, Down’s syndrome)

uncertain diagnosis
- acute epiglottitis
- bacterial tracheitis
- peritonsillar abscess
- foreign body inhalation

Question 8

Most croup diagnoses are made clinically. What can be seen on a CXR if completed?

Answer 8

‘steeple sign’

subglottic narrowing

Question 9

Management of Croup

Answer 9

Emergency
- high flow O2
- nebulised adrenaline
- STAT dose of oral dexamethasone (0.15mg/kg) regardless of severity