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Croup & epiglottitis

Laryngotracheitis subglottica et epiglottitis · Laryngitida (krup) a epiglotitida

What it is

Upper-airway swelling in children — croup is viral and barky, epiglottitis is bacterial and lethal.

Symptoms & signs

  • Barking cough
  • stridor
  • hoarseness
  • drooling and tripod posture in epiglottitis
  • fever

🚩 Get help if…

  • call 112 / 911 now Drooling, can't swallow, or sitting forward to breathe
  • call 112 / 911 now Noisy breathing at rest with skin sucking in under the ribs
  • call 112 / 911 now Blue or grey lips, or very drowsy
  • see a doctor soon High fever with a child who looks very ill

Where it strikes

Medical treatment

  • Single-dose dexamethasone
  • nebulised adrenaline
  • epiglottitis: airway secured in theatre + IV antibiotics
  • Hib vaccination

Natural & lifestyle

  • Calm the child (crying worsens obstruction)
  • humidified air or steam — no benefit in trials not confirmed in trials
  • upright positioning

Emerging & experimental

  • Heliox for severe obstruction

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Steam and mist tents — traditional; trials found no benefit not confirmed in trials
  • Taking the child into cold night air — parents' experience; not shown in a small trial anecdotal / traditional

ICD codes