A 2-year-old girl is brought to the ED by her parents. They state that she has been suffering from a cold for five days. They became concerned when she developed a barking cough and noisy breathing. Examination reveals a listless child with a mild fever, inspiratory stridor, and diminished breath sounds.
Which one of the following is the most likely pathogen?
Correct Answer C:
Croup is acute inflammation of the upper and lower respiratory tracts caused most commonly by parainfluenza virus type 1 infection. It is characterized by a barking cough and inspiratory stridor. Diagnosis is usually obvious clinically but can be made by anteroposterior neck x-ray. Treatment is antipyretics, hydration, nebulized racemic epinephrine, and corticosteroids. Prognosis is excellent.
Which of the following steps is not indicated in the management of croup?
Correct Answer D:
Croup is acute inflammation of the upper and lower respiratory tracts caused most commonly by parainfluenza virus type 1 infection. It is characterized by a barking cough and inspiratory stridor. Diagnosis is usually obvious clinically but can be made by anteroposterior neck x-ray.
Treatment:
Which one of the following has been shown to reduce the croup score in children and lead to shorter hospital stays?
Correct Answer A:
Croup is a viral illness and is not treated with antibiotics. Racemic epinephrine may be used acutely, but rebound can occur. Albuterol has not been shown to be helpful. Oral or intramuscular dexamethasone, 0.6 mg/kg as a single dose, and nebulized budesonide have been shown to reduce croup scores and shorten hospital stays.
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