Epiglottitis vs croup

Question 1

CXR findings differnence

Answer 1

E - lateral view thumb sign
C - PA view steeple sign aka narrowing of subglottis

Question 2

What questions can you ask / observe to differentiate between the two?

Answer 2

Cough?
Speaking?

Neither in epiglottitis

Question 3

Difference in fever

Answer 3

more than 38.5 in epiglottitis
less than 38.5 in croup

Question 4

Management of epiglottitis

Answer 4

ENT and anaesthetic referral
secure airway with endotracheal intubation
Give o2

Take blood cultures

Give antibiotics and prophy abx for household contacts

Question 5

1st line abx for epiglottitis

Answer 5

Empircal IV cefuroxime + dex

Question 6

2nd line for epiglottitis

Answer 6

Chloramphenicol

Question 7

What do you give for household contacts for pt with epi

Answer 7

RIFAMPICIN

Question 8

Complications for pt with epi

Answer 8

Pneumonia
Mediastinitis
Neck infection

Question 9

When do you admit in croup? / scoring system

Answer 9

Westley scoring system

STRIDOR = ADMISSION

Anything more than mild

Moderate = stridor at rest
Severe = stridor + distress

Question 10

Mx of moderate croup

Answer 10

PO dex OR nebulised steroids

Question 11

Mx of severe croup

Answer 11

Admit
Oral / IV dex
Nebulised adrenaline with oxygen via non rebreathe mask
Consider securing airway