croup

Question 1

• MC infectious cause of airway obstruction in children
• Usually occurs between ages of 6 months and 3 years
• Viral infection  MC parainfluenza virus (numerous other organisms have been reported)
• Symptoms occur as a result of mucosal edema in the larynx, trachea, and bronchi

Answer 1

croup

Question 2

• Gradual in onset and often preceded by an upper respiratory tract infection
• Nasal congestion, rhinorrhea, cough, low-grade fever
• Barking cough, hoarseness and stridor
• If stridor present usually inspiratory in nature
• If becomes biphasic – may indicate severe airway obstruction
• Typically, last between 3-5 days but may be infectious for 2 weeks

Answer 2

signs and symptoms of croup

Question 3

croup diagnosis

Answer 3

• Clinical findings – physical exam, pulse oximeter
• Steeple sign may be apparent on plain-film x-ray of neck
• CBC may show leukocytosis

Question 4

croup TREATMENT

Answer 4

• If child has significant symptoms of airway obstruction – manage like epiglottitis
• > 85% of cases are mild and can be managed outpatient
• Humidified room
• Moderate to severe croup (stridor at rest)
• Nebulized racemic epinephrine 0.5 mL/kg nebulized (5 mL maximum)
• All patients with croup, whether mild, moderate, or severe, benefit from oral steroid as one-time dose
• Dexamethasone 0.15-0.6 mg/kg PO/IM (10 mg maximum)
• Consider nebulized budesonide 2 mg if PO steroids vomited