Airway Disease Flashcards
What is croup?
Croup is an acute viral disease of early childhood, usually occurring from age 6 months to 5 years (and more in males than in females), marked by a resonant barking cough (described as sounding “seal-like”), stridor, and varying degrees of respiratory distress. Inflammation and spasm of the larynx, trachea, and bronchi account for most of the symptoms; thus croup is also known as laryngotracheobronchitis.
Etiology: Although bacterial infections of the larynx can result in “false croup,” the condition is caused almost exclusively by viruses, esp. parainfluenza, respiratory syncytial, and influenza viruses.
Diagnosis: Diagnosis is based on characteristic clinical findings and x-ray examination of the neck, which may show subglottic narrowing of air within the trachea.
Treatment: Supportive measures include rest and supervised hydration. Positioning in an infant seat or in Fowler’s position is helpful. Although cool mist is often provided via inhalation, its effectiveness is unproven. Oral corticosteroids are routinely prescribed and have proved beneficial in mild as well as moderate to severe cases (less sleep loss, better clinical outcomes in early days). Hospitalization may be necessary for more severe cases; nebulized racemic epinephrine and oxygen therapy may be needed. Intubation is rarely required unless the patient shows evidence of respiratory fatigue or hypoxia. Antibiotics are seldom needed because the viruses involved do not predispose to secondary bacterial infections. The vast majority of children, even those hospitalized, recover without complications.
