Paediatrics: Respiratory - Croup and Acute Epiglottitis (see note Assessing the Child With Stridor)

Laryngeal & tracheal infxn's cause mucosal inflammation & swelling. This can rapidly cause life-threatening obstruction of the airway in young children. Several conditions can cause acute upper airways obstruction - what are they?

Laryngeal & tracheal infxn's are characterised by what signs?

How is upper airway obstruction assessed for severity?

With laryngotracheobronchitis (croup), there is mucosal inflammation & ^secretions affecting the airway, but it is oedema of subglottic area that is potentially dangerous in young children as it may result in critical narrowing of trachea. What are the common causes of croup & when is the peak incidence?

What are typical features of croup?

Mx of croup.

Acute epiglottitis is a life-threatening emergency. Caused by H. influenzae type b. In UK introduction of universal Hib immunisation has led to a >99% reduction in incidence of epiglottitis. There is intense swelling of the epiglottis & surrounding tissues associated with septicaemia. What is the peak age of incidence & key signs & Sx?

Mx of acute epiglottitis.

Outline differences in clinical features between croup & acute epiglottitis. Box from ITOP p281.