Croup and Bacterial Tracheitis Flashcards
What is Croup? What is it caused by?
A viral upper respiratory tract infection (URTI) which causes nasopharyngeal inflammation.
It may spread to the larynx and trachea, causing subglottal inflammation, oedema and compromise of the airway.
Most commonly parainfluenza virus but can be caused by many viruses.
What is the common presentation of croup?
Infant 6months - 3yo.
Few day hx of coryza.
Develops sore throat and ‘barking’ cough.
Increasing respiratory distress worse at night.
How should crop be managed?
First line: Oral dexamethasone. (other steroids can be used)
Severe croup (aka no improvement) :
Nebulised epinephrine (adrenaline) with oxygen by facemask provides transient improvement.
Ensure there is anaethetist/intensive monitoring as rebound symptoms often occur after 2 hours.
What are the major differentiating features between croup and epiglottitis?
Croup develops over days, epiglottitis over hours.
Croup a barking cough is a significant feature, epiglottitis cough is not common.
Croup childs voice will be hoarse, epiglottitis child will be unwilling to talk voice will be soft.
Airway obstruction is more severe in epiglottitis (drooling inable to swallow)
Child will look more ill in epiglottitis.
What is bacterial tracheitis?
It is a rare bacterial infection of the trachea and may occur following a URTI.
This condition is also called pseudomembranous croup.
What is the cause of bacterial tracheitis?
Staph aureus
How does bacterial tracheitis present?
More common in young children highest incidence at 4yo, but can occur unto 16yo.
Presents very similarly to croup.
However the child will appear more ill and have a very high fever and more rapidly progressing airway obstruction.
It often presents as croup which is not responding to treatment.
How do you manage bacterial tracheitis?
Iv antibiotics.
Intubation if required.
