stridor And Respiratory Infections Flashcards
Croup cause?
Parainfluenza viruses
peak incidence of croup?
6 months - 3 years
more common in autumn
Acute epiglottitis cause?
Haemophilus influenzae type B
ncidence of epiglottitis has decreased since the introduction of the Hib vaccine
peak incidence of Acute epiglottitis?
2 and 6 years
features of acute epiglottis?
rapid onset
unwell, toxic child
stridor
drooling of saliva
Laryngomalacia peak incidence?
neonate
present at 4 weeks of age with:
stridor
Whoooijg cough is caused by?
Bordatella pertussis
Features of whooping cough ?
Paroxysmal cough.
Inspiratory whoop.
Post-tussive vomiting.
Undiagnosed apnoeic attacks in young infants.
Spells of apnea
Diagnosis of whooping cough
Nasal swab
PCR and serology - quicker
Mx of whooping cough
Under 6 months should be admitted
Notifiable disease
Start on oral macrolide - azithromycin / clarithromycin IF ONSET IS WITHIN 21DAYS
Women who are between 16-32 weeks pregnant will be offered the vaccine.
For whooping cough household contacts should receive
PROPHYLATIC ANTIBIOTCS
School exclusion of whoooing cough
48 hours after commencing antibiotics
21 days of symptom onset if no abx
Severity of CROUP
Mild
Occasional barking cough
No stridor at rest
Moderate
Frequent barking cough
Audible stridor at rest
Pasternal and sternal wall retraction at rest
Child placated
Severe
Prominent stridor at rest
Significant distress and agitation
Tachycardia occurs with more severe obstructive symptoms and hypoxaemia
When to admit patient with croup ?
Less than 3 months
Moderate to severe croup
Upper airway abnormalities - Down syndrome
Laryngomakacia
Investigation of croup ?
CXR
PA - subglottic narrowing
Steeple sign
Lateral view
Thumb sign
