Compare Epiglottis vs Croup
Common words:
- etiology – predisposing Factors
- prevalence / incidence
- age – timing – onset – progression
| Terms to Learn | Epiglottis | Croup (LTB = LaryngoTracheoBrochitis) |
| Etiology | S. aureus
S. pneumonia, S. pyogenes H. influenza type B |
Parainfluenza 1,2,3 |
| Age | Toddler-young school age | Preschool |
| Timing | Year round | Cool month |
| Best initial test | Laryngoscopy | Clinical Dx
(CXR steeple sign) |
| Most accurate test | C&S from tracheal aspirate | PCR for virus |
| Best initial treatment | Intubation | None or nebulized epinephrine if severe |
| Definitive treatment | Airway
Broad-spectrum Abx |
|
| Prevalence | Very rare (due to Hib vaccine) | Very common |
| Common agents | H.influenza type B | Parainfluenza 1,2,3
RSV, enterovirus |
| Age | 3 – 7 years | 3 months – 3 years |
| Onset | Rapid | URI prodrome |
| Physical exam | Quiet stridor
Toxic Respiratory distress 3Ds: drooling, dysphagia, dysphonia |
Barking cough, stridor, non-toxic |
| Fever | > 39 | <39 |
| WBC | elevated | normal |
| X-ray | steeple sign | thumbprint sign |
| Treatment | intubate/ventilate
antibiotics: cefuroxime |
humidified air
oxygen if hypoxic racemic epinephrine dexamethasone |
| Incidence | 5% of children with stridor | >80% children with stridor |
| Site of obstruction | supraglottic | subglottic |
| Etiology | bacterial | viral |
| Age | 2-6 years | < 2 years |
| Onset | sudden (hours) | gradual |
| Progression | rapid | slow, variable |
| Position | insists on sitting up and leaning forward
sitting forward with mouth open |
can lie down
comfortable in different positions |
| Dysphagia | severe | absent |
| Drooling | resent | absent |
| Cough | suppressed | barking |
| Voice | muffled | hoarse |
| Fever | often > 39 | rarely > 39 |
| Respiratory pattern | tachypnea | rapid, struggling |
| Clinical appearance | toxic | non-toxic |
| Diagnosis | direct visualization | clinical |
| Treatment | OR for airway management / intubation
2nd/3rd cephalosporin |
dexamethasone 0.15-0.6mg/kg orally
nebulized racemic epi |
| Boy : girl | 1.5 : 1 |