Croup

Question 1

What is croup?

Answer 1

Acute inflammatory disease of the larynx including:

• viral croup (laryngotracheobronchitis)
• epiglottitis (supraglottitis)
• bacterial tracheitis

Question 2

What are the major Ddx for a child presenting with stridor?

Answer 2

Main differentials for patients presenting with acute stridor

• viral croup (laryngotracheobronchitis)
• epiglottitis (supraglottitis)
• bacterial tracheitis
• spasmodic croup
• FB
• retropharyngeal abscess

Question 3

Viruses mot commonly causing croup?

Answer 3

Parainfluenza virus most common.
Also:
- RSV
- Human coronavirus NL63
- Rhinovirus
- Human metapneumovirus

Question 4

Peak season for croup?

Answer 4

Fall and early winter months

Question 5

CFx of croup presentation?

Answer 5

• prodrome of URTI symptoms then
• barking cough
• stridor
• Fever usually low grade or absent
  If severe, may develop stridor at rest, air hunger, retractions and cyanosis

Question 6

What features on PEx favour croup over epiglottitis?

Answer 6

Presence of cough and absence of drooling

Question 7

Treatment of mild viral croup?

Answer 7

Symptomatic.

MILD: supportive, oral hydration, minimal handling

Question 8

What signifies mild croup?

Answer 8

Barking cough and no stridor at rest

Question 9

Treatment of severe croup?

Answer 9

• oxygen
• neb epinephrine
• dexamethasone 0.6mg/kg IM