Croup and Epiglottitis
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| Croup and Epiglottitis |
Croup
Croup is acute laryngotracheobronchitis, laryngotracheitis " viral croup " is the most common from infectious croup.
Causative agent:
Parainfluenza virus, respiratory syncytial virus, influenza virus during epidemics and rhinovirus.Age and incidence:
3 month to 3-5 years in cold weather.Clinical manifestations:
- Onset is gradual and progresses slowly, following 1 to several days after URTI.- A brassy cough, hoarseness of voice and inspiratory stridor.
- Low-grade fever.
- Increase respiratory and pulse rate.
- Restlessness, hypoxia and cyanosis.
Diagnostic evaluation:
History and physical examination.Later sign of increased PaCO2 " blood gases analysis".
Normal to mild leukocytosis.
X-ray of the neck ( subglottic oedema).
Treatment:
Supportive therapy.High humidification with oxygen.
Increase fluid intake " good hydration".
Racemic epinephrine nebulizer.
Minimal handling.
Complication:
Airway obstruction " need nasotracheal intubation.Epiglottitis
Causative agent:
Caused mainly by H. Influenza, other agents include pneumococci and staph aureus.Age:- 3-10 years with seasonal variations.
Clinical manifestation:
- Onset and progression are rapid.- High fever, aphonia, drooling and inspiratory stridor.
- Irritability with the hyperextended neck.
- Cherry red epiglottis.
- Refusal to eat.
- Intercostal retraction.
Diagnostic evaluation:
- History and physical examination.- Leukocytosis.
- X-Ray neck " epiglottic edema".
- ABG analysis " increased PaCO2 at the late stage.
Treatment:
- Medical emergency " endotracheal intubation".- Cool humidified oxygen.
- Antibiotic therapy.
- Quit room and bed rest.
- Increase fluids.
- Observe for signs of respiratory distress.
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