A 9-month-old child presented to the ER with characteristic "barking" cough and hoarseness of voice. She had a history of rhinorrhoea, pharyngitis, mild cough, and low-grade fever for 1-3 days. Symptom worsened at night. O/E: - Normal to moderately inflamed pharynx Increased respiratory rate Nasal flaring Suprasternal, infrasternal, and intercostal retractions Continuous inspiratory stridor X-RAY NECK All of the following statements are true about the treatment of the above condition except: -
This is a case of acute laryngotracheobronchitis (croup). Acute infectious process M/C cause- parainfluenza viruses (types 1, 2, and 3) Presents with: - Bark-like / Brassy cough Hoarseness Inspiratory stridor Respiratory distress 4. Treatment Mainstay - airway management and treatment of hypoxia. Nebulized racemic epinephrine for moderate or severe croup. Oral steroids -beneficial even in mild croup
Nebulized racemic epinephrine is an accepted treatment for moderate or severe croup.
Patients can be safely discharged home after a 2-3 hr period of observation provided, they have no stridor at rest; have normal air entry, normal pulse oximetry, and normal level of consciousness; and have received steroids.
Coicosteroids decrease the edema in the laryngeal mucosa through their anti-inflammatory action.
Oral steroids are not beneficial in mild croup
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