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Croup (Laryngotracheobronchitis) - Coggle Diagram
Croup (Laryngotracheobronchitis)
Pseudomembranous croup (bacterial tracheitis)
rare
dangerous
similar to severe viral croup but with high fever, toxic appearance, rapidly progressive airway obstruction, copious thick airway secretions
caused by S Aureus
IV antibiotics + intubations + ventilation if required
Intro
mucosal inflamm + increased secretions
oedema of subglottic area potentially dangerous in young children, may result in critical narrowing of trachea
occurs from 6mo-6yrs
peaks in 2nd yr of life
peaks in autumn
if recurrent, may be a/w atopy
Causative organisms
viral in >95%
parainfluenza = commonest cause
human metapneumonvirus
RSV
influenza
Clinical features
barking cough
harsh stridor
hoarseness
usually preceded by fever + coryza
sx often start + are worse @ night
Management
mild
stridor + chest recession disappear when child @ rest
can usually be managed @ home
parents must be observant
severe
give neb adrenaline + O2
risk of rebound sx after adrenaline wears off after 2hr
advice from anaesthetist
only a few require intubation
other things that influence @ home vs hosp management
time of day
ease of access to hosp
child's age (low threshold for admission if <12mo due to narrow airway)
parental understanding + confidence
warm moist air widely used but unproven benefit
oral dexamethasone/prednisolone
neb steroids (budesonide)