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Laryngotracheobronchitis (Croup) (Clinical Signs & Symptoms (Patient…
Laryngotracheobronchitis (Croup)
Etiology
Viral infection of the upper airway
Parainfluenza virus is the most common cause
Influenza A and B
RSV
Adenovirus
Pathophysiology
The infection causes inflammation of the larynx, trachea, bronchi, bronchioles and the lung parenchyma
Obstruction caused by swelling and inflammatory exudates develops and becomes pronounced in the subglottic region
Obstruction increases WOB. Atelectasis may occur if the bronchioles are obstructed
Clinical Signs & Symptoms
Patient is 6 months to 3 years of age
Tachypnea and Tachycardia
Diminished breath sounds
Inspiratory Stridor
Accessory muscle usage
Substernal Retractions
Diagnostic Tests
Lateral Neck radiograph to rule out epiglottitis
AP Chest X-ray showing "Church steeple" appearance which is narrowing of the trachea
Patient age: 6 months to 3 years
Respiratory Management
Oxygen Support to keep SpO2 above 90%
Cool humidified air
Corticosteroid (budesonide is an option)
Differential Diagnosis
Epiglottitis
Allergy
Subglottic stenosis
Uvulitis
Tracheomalacia
Vocal Cord Paralysis