Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: Dec 25 2021


  • Snapshot
    • A 5-year-old girl is brought to urgent care for difficulty breathing. For the past few days, she has had low-grade fevers, a runny nose, and a slight cough. On physical exam, she has a seal-like barking cough and audible inspiratory stridor. There is accessory muscle use with breathing. Her lung exam was normal without any wheezes. She is given the appropriate treatments for this condition, and the physician informs the family that this is likely viral and common in children.
  • Introduction
    • Clinical definition
      • upper respiratory infection characterized by barking cough
  • Epidemiology
    • Incidence
      • common
    • Demographics
      • children < 6 years of age
      • boys > girls
  • Etiology
    • Parainfluenza virus (most common)
      • a paramyxovirus
        • RNA virus
    • Influenza virus
      • orthomyxovirus
        • RNA virus
    • Pathogenesis
      • the virus causes inflammation of the upper airway
        • edema, epithelial necrosis, and infiltration of inflammatory cells
        • this causes narrowing of subglottic airway, resulting in stridor and increased work of breath
    • Associated conditions
      • bronchiolitis
  • Presentation
    • Symptoms
      • “seal-like” deep barking cough
      • difficulty breathing
      • sore throat
      • hoarseness
      • congestion
      • symptoms are worse at night
    • Physical exam
      • fever
      • inspiratory stridor
      • tachypnea
      • accessory muscle use
      • pulsus paradoxus with severe croup and upper airway obstruction
  • Imaging
    • Chest radiography
      • indication
        • all patients
      • findings
        • may show a steeple sign indicating subglottic narrowing
  • Differential
    • Acute epiglottitis
      • distinguishing factors
        • patients typically have muffled voice, drooling, high fever, and have dysphagia
        • a medical emergency
        • absence of barking cough
    • Tracheal and subglottic stenosis
      • distinguishing factors
        • can be congenital or from prolonged intubation in critically ill patients
        • inspiratory stridor
        • hoarse voice
        • absence of systemic symptoms including fever
    • Making the diagnosis
      • based on clinical presentation
  • Treatment
    • Conservative
      • supportive care
        • indication
          • all patients
        • modalities
          • supplemental oxygen
          • hydration
    • Medical
      • single dose of steroids
        • indication
          • all patients
      • nebulized epinephrine
        • indications
          • moderate-severe croup
      • cool mist
        • indications
          • mild-moderate croup
  • Complications
    • Respiratory failure
    • Pneumonia
  • Prognosis
    • Most cases resolve without complications
1 of 0
1 of 5
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options