Croup

Question 1

Aetiology of croup

Answer 1

• Parainfluenza virus

Question 2

Epidemiology of croup

Answer 2

• 6 months - 6 years

Question 3

Presentation of croup

Answer 3

• History
  
  • Barking cough
  • Harsh stridor
  • Hoarseness
  • Prodromal fever and coryza
• Examination
  
  • Respiratory distress (severe)
    
    • Stridor
    • Sub/intercostal recessions
• Symptoms are worse at night
• Stridor at rest/during sleep indicates increased severity

Question 4

Differential diagnosis of croup

Answer 4

• Epiglottitis
  
  • Hib (rare since vaccine)
  • Rapid onset
  • Toxic
  • Drooling
  • Absent cough
  • Soft/absent stridor
• Bacterial tracheitis
  
  • Staph aureus
• Foreign body
• Anaphylaxis

Question 5

Investigations for croup

Answer 5

• Clinical diagnosis

Question 6

Management of croup

Answer 6

• Dexamethasone (PO/IM)
• Budesonide (neb)
• Adrenaline (neb) + oxygen
  
  • Call anaesthetist
• Intubation