Croup

Question 1

Another name for croup

Answer 1

Laryngotracheobronchitis

Question 2

What is it?

Answer 2

Upper airway obstruction due to inflammation. Caused by a VIRAL INFECTION (usually parainfluenza 1 or 3)

Question 3

Most common age affected

Answer 3

6 months - 6 years

Question 4

Usual duration of illness

Answer 4

3-5 days

Question 5

Presentation

Answer 5

Sudden-onset seal-like barking cough

Stridor, hoarse voice, resp distress

Coryza + fever may be present in first 24-48 hours

Question 6

2 exacerbating factors

Answer 6

Worse at night + if agitated

Question 7

Features of mild croup

Answer 7

Seal bark cough

NO stridor or intercostal recession

Question 8

Features of moderate croup

Answer 8

Cough + stridor + sternal recession

NO agitation or lethargy

Question 9

Features of severe croup

Answer 9

Inclused agitation + lethargy

Question 10

Features of impending resp failure

Answer 10

Inc obstruction, interostal recession, asynchronous chest wall + abdo movement
Fatigue/ pallor/cyanosis

Question 11

Mx of mild croup

Answer 11

Single dose of oral dexamethosone (0.15mg/kg)

Question 12

Mx of moderate-severe croup

Answer 12

ADMIT!!
Corticosteroids
NEBULISED EPINEPHRINE WITH 8L/MIN OXYGEN

Question 13

DDx:

What is bacterial tracheitis?

Answer 13

Rare complication of flu

Fever, suden-onset stridor + resp distress following a resp illlness

May seem to be improving, then gets suddenly worse

Question 14

DDx:

Retropharyngeal/ peritonsillar abscess

Answer 14

More gradual onset

Fever, unilateral cervical lymphadenopathy, neck stiffness