Presentation: Cough Flashcards
What is croup?
Croup is a form of upper respiratory tract infection seen in infants and toddlers, characterised by stridor caused by laryngeal oedema and secretions. Parainfluenza viruses account for the majority of cases.
What is the peak incidence age for croup?
The peak incidence for croup is between 6 months and 3 years.
When is croup more common?
Croup is more common in autumn.
What are the main features of croup?
Main features include a barking cough, stridor, fever, coryzal symptoms, and increased work of breathing.
What should be avoided during a croup examination?
The throat should not be examined due to the risk of precipitating airway obstruction.
What are the severity grades of croup?
Severity is graded as Mild, Moderate, and Severe.
What characterises mild croup?
Mild croup includes an occasional barking cough, no audible stridor at rest, and the child is happy and willing to eat, drink, and play.
What characterises moderate croup?
Moderate croup includes a frequent barking cough, easily audible stridor at rest, and the child can be placated.
What characterises severe croup?
Severe croup includes frequent barking cough, prominent stridor at rest, marked retractions, and significant distress or lethargy.
Who should be admitted for croup?
Children with moderate or severe croup, those under 3 months of age, known upper airway abnormalities, or uncertainty about diagnosis should be admitted.
What are common differentials for croup?
Important differentials include acute epiglottitis, bacterial tracheitis, peritonsillar abscess, and foreign body inhalation.
How is croup diagnosed?
The vast majority of children are diagnosed clinically.
What does a chest x-ray show in croup?
A posterior-anterior view shows subglottic narrowing, known as the ‘steeple sign’.
What is the management recommendation for croup?
NICE recommends giving a single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity.
What is an alternative to dexamethasone for croup management?
Prednisolone is an alternative if dexamethasone is not available.
