Croup and Epiglottitis

Croup and Epiglottitis
Croup and Epiglottitis 


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).


Supportive therapy.

High humidification with oxygen.

Increase fluid intake " good hydration".

Racemic epinephrine nebulizer.

Minimal handling.


Airway obstruction " need nasotracheal intubation.


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.


- Medical emergency " endotracheal intubation".

- Cool humidified oxygen.

- Antibiotic therapy.

- Quit room and bed rest.

- Increase fluids.

- Observe for signs of respiratory distress.


Spina Bifida

Otitis Media

Ectopic Pregnancy

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