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CROUP (Laryngotracheobronchitis) (Clinical Sings & Symptoms (Slow…
CROUP (Laryngotracheobronchitis)
Differential Diagnosis
Differentiate between Croup and Epiglottitis
Inspiratory stridor - high pitched, brassy, loud :red_flag:
Cough - present :red_flag:
CXR - "steeple appearance" :red_flag:
Etiology
Parainfluenza virus Type 1 (most common) Type 3 (least common)
Influenza A and B
RSV (respiratory syncytial virus)
Herpes simplex virus
Myoplasma pneumoniae
Rhinovirus
Adenoviruses
Pathophysiology
Inflammatory process that causes edema and swelling of the mucous membranes
When edema develops in the upper airway, fluid spreads and accumulates quickly throughout the connective tissues, which causes mucosa to swell and the airway lumen to narrow
Mucous glands increase mucous production and cilia lose their effectiveness
Diagnostic Testing
CXR
ANTERIO-POSTERIOR NECK CXR
"Steeple point" :red_flag:
Physical exam findings
Respiratory Management
Close respiratory and cardiac monitoring
Corticosteroids
Droplet precautions if admitted to hospital
Supplemental oxygen
Racemic epinephrine
Based on the LTB scoring system
3-5 consider racemic epinephrine
6 Administer racemic epinephrine 0.5mL in 3 mL NS
Clinical Sings & Symptoms
Slow onset
Hoarseness
Barking cough
Inspiratory stridor - high pitched, brassy, loud :red_flag:
Intercostal retractions may be present (severe)
Tachypnea
Tachycardia
Lethargy
Hypotonia
Cyanosis
SUBglottic airway obstruction
Viral infection seen in children 6 months to 5 years old