Acute laryngotracheobronchitis (croup) – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

January 5, 2021 5:38 am Published by

Acute laryngotracheobronchitis (croup) is an inflammation of the tissues in the subglottic space, causing swelling of the mucosal lining and production of thick, viscous, mucopurulent exudate, which comprises the upper airway. It is most commonly preceded by an upper respiratory tract infection and usually affects children aged 4 months to 5 years.

Sn. & Sx.:

  • Triad: stridor, subglottic swelling, croupy (“seal bark”) cough
  • Biphasic stridor and cough
  • Asynchronous chest wall and abdominal movement
  • Hypoxia (pallor, cyanosis)

dDx.:

  • Upper respiratory tract infection
  • Acute or chronic bronchitis
  • Epiglottitis
  • Diphtheria
  • Bronchiectasis
  • Retropharynge al or peritonsillar abscess
  • Neoplasm
  • Asthma
  • Chronic obstructive pulmonary disease

Sequelae:

  • Bacterial tracheitis
  • Airway obstruction and hypoxemia

Work up:

  • Imaging (X-ray showing “steeple” sign)

Tx.:

  • Epinephrine
  • Systemic corticosteroids (dexamethasone, prednisone)

Categorised in:

This post was written by Omar Rifai