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Spasmodic Croup


Presentation

  • The characteristic barky cough is present, but there are no other signs of viral illness. The child is perfectly fine the next morning, only to have a repeat of symptoms the next 2 or 3 nights. Hospitalization is rarely required.[medical-dictionary.thefreedictionary.com]
  • (note that viral croup presents with a prodrome) NO FEVER Spasmodic croup usually resolves quickly with exposure to humidified air, only to recur for the next few days .[johnsarm.net]
  • Abstract Recurrent inspiratory stridor, for which there appears to be no organic basis, can present a serious medical problem.[ncbi.nlm.nih.gov]
  • The characteristic barking cough and hoarseness may be present, but there is no stridor at rest. A total score of 3–5 is classified as moderate croup. It presents with easily heard stridor, but with few other signs.[en.wikipedia.org]
Cough
  • When the voice box and upper airway organs become inflamed, there is slight fever and a croupy cough. Severe inflammation causes barking, noisy inspiration and a metallic cough.[standardfirstaidcourses.ca]
  • As the upper airway becomes more inflamed and swollen, the child may become hoarse, with a harsh, barking cough. This loud cough, which is characteristic of croup.[ufmcpueblo.com]
  • Coughing is sometimes severe at night or when the child is crying or excited and happens with loud and raspy breathing. Coughing is similar to the barking of a seal.[standardfirstaidtraining.com]
  • Symptoms Croup features a cough that sounds like a seal barking. Most children have what appears to be a mild cold for several days before the barking cough becomes evident.[herbmuseum.ca]
  • As evening approaches an occasional hollow, barking, evidently painful cough is noticed and the voice is very hoarse; toward midnight the cough becomes more brazen and more frequent and the breathing difficult.[chestofbooks.com]
Stridor
  • Our results show that stridor in this patient was due to dynamic inspiratory constriction of the vocal cords.[ncbi.nlm.nih.gov]
  • Spasmodic croup (laryngismus stridulus) occurs at night clinical picture similar to that of viral croup. symptoms begin suddenly and are characterized by a sudden onset of dyspnea barklike cough stridor in a previously healthy child.[johnsarm.net]
  • The characteristic barking cough and hoarseness may be present, but there is no stridor at rest. A total score of 3–5 is classified as moderate croup. It presents with easily heard stridor, but with few other signs.[en.wikipedia.org]
  • They said to bring them in if they are doing the really sucky in tummy breathing, its called stridor I think. Some children are just prone to it. This is page 1 of 1 (This thread has 3 messages.)[mumsnet.com]
  • The coughing is similar to a seal barks When inhaling, a high pitched voice can be heard which is known as stridor The face becomes red and congested with an anxious expression Sometimes, the lips turns blue due to the lack of oxygen The voice becomes[standardfirstaidcourses.ca]
Hematochezia
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself[nejm.org]
Constipation
  • The exciting causes are exposure to cold, dampness, and high winds, overeating, and indigestion and constipation. An attack may come on suddenly or be preceded by hoarseness or by the symptoms of nasal catarrh.[chestofbooks.com]
  • From: US National Library of Medicine-Croup "Cannabis indica is one of the best additions to cough mixtures that we possess, as it quiets the tickling in the throat, and yet does not constipate or depress the system as does morphine." - A Textbook of[herbmuseum.ca]
Flushing
  • Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed.[webmd.com]
  • The face has an anxious expression; the cheeks are flushed, although the lips may be bluish, and the forehead is covered with drops of perspiration. The breathing is slow and labored and any excitement or effort increases the difficulty.[chestofbooks.com]
Fussiness
  • During this period child is fussy therefore a Popsicle which is liked by all children will be useful. Fluid intake helps to thin the mucus collected in nose and throat. It facilitates the child to breath easily.[tandurust.com]
Panic Attacks

Workup

  • (See Prognosis, Clinical, and Workup.) Patient education For patient education information, see the Lung Disease and Respiratory Health Center, as well as Croup.[emedicine.medscape.com]
  • (See Prognosis, Clinical, and Workup.) Patient education For patient education information, see the Lung Disease and Respiratory Health Center , as well as Croup .[emedicine.medscape.com]
  • Differential Diagnosis of Children with Severe Respiratory Symptoms Condition History Physical examination Workup Common etiologies Angioedema Detailed questioning to identify the offending antigen Swelling of face and neck Epicutaneous skin testing or[aafp.org]

Treatment

  • Since, in most cases, the pediatrician will be able to differentiate between LT and SC at admission by history and clinical signs, it seems that steroid treatment should be avoided in cases of LT and may be of benefit in some cases of SC.[ncbi.nlm.nih.gov]
  • Corticosteroid treatment of laryngotracheitis vs spasmodic croup in children.[medical-dictionary.thefreedictionary.com]
  • We went to the children's hospital with him for emergency treatment because he was turning blue, and when the emt checked his oxygen levels they were dangerously low.[mothering.com]
  • I regard its employment as quite an advance on the antiquated ipecac, turpeth mineral, et id omne genus treatment, and for many years I have used it to the exclusion of all such.[jamanetwork.com]

Prognosis

  • (See Prognosis, Clinical, and Workup.) Patient education For patient education information, see the Lung Disease and Respiratory Health Center, as well as Croup.[emedicine.medscape.com]
  • (See Prognosis, Clinical, and Workup.) Patient education For patient education information, see the Lung Disease and Respiratory Health Center , as well as Croup .[emedicine.medscape.com]
  • Prognosis: —The prognosis is good, death seldom occurring from spasmodic croup. Treatment: —The treatment of the inflammatory form is simple and effectual, the entire train of symptoms may be abated in some cases by the use of aconite alone.[henriettes-herb.com]
  • Prognosis Croup is usually a mild condition which clears up without intensive treatment. However, complications are possible and the condition can be fatal in very rare cases when the airways become completely blocked.[medic8.com]

Etiology

  • An allergic etiology is suspected. Antihistamines are sometimes helpful. References in periodicals archive ? Corticosteroid treatment of laryngotracheitis vs spasmodic croup in children.[medical-dictionary.thefreedictionary.com]
  • Among the noninfectious etiologies of this syndrome are foreign body aspiration, trauma (eg, due to intubation), and allergic reaction (eg, acute angioneurotic edema).[pedsinreview.aappublications.org]
  • Croup is the most common etiology for hoarseness, cough, and onset of acute stridor in febrile children. Symptoms of coryza may be absent, mild, or marked.[emedicine.medscape.com]

Epidemiology

  • (See Etiology, Epidemiology, Prognosis, Clinical, and Treatment.) Croup manifests as hoarseness, a seal-like barking cough, inspiratory stridor, and a variable degree of respiratory distress.[emedicine.medscape.com]
  • Studies suggest a specific association between croup and the novel coronavirus NL63. [ 4 ] Epidemiology Croup most often affects children aged 6 months to 3 years, with a peak incidence during the second year of life.[patient.info]
  • Changing epidemiology of life-threatening upper airway infections: the reemergence of bacterial tracheitis. Pediatrics. 2006;118(4):1418–1421. 22. Chan A, Langley J, Leblanc J. Interobserver variability of croup scoring in clinical practice.[aafp.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology The infection causes inflammation of the larynx, trachea, bronchi, bronchioles, and lung parenchyma. Obstruction caused by swelling and inflammatory exudates develops and becomes pronounced in the subglottic region.[merckmanuals.com]
  • Pathophysiology Viral upper respiratory tract infection (URTI) causes nasopharyngeal inflammation that may spread to the larynx and trachea, causing subglottal inflammation, oedema and compromise of the airway at its narrowest portion.[patient.info]
  • Pathophysiology Subglottic infection, inflammation and edema Tracheal edema at the most narrow aspect of a child's airway Subglottic area is 4 mm in a typical infant (and croup may decrease this to 2 mm area) Every mm of airway area lost results in a[fpnotebook.com]
  • EPINEPHRINE A number of small randomized controlled trials have shown that nebulized epinephrine is an effective treatment for moderate to severe croup, with benefits such as reduction in croup severity, various objective pathophysiologic measures, and[aafp.org]

Prevention

  • Make sure hot water vaporizers should be out of reach of children in order to help prevent accidental burns.[standardfirstaidcourses.ca]
  • Ways in preventing viral infections that causes croup Wash hands properly especially after blowing the nose and also wash hands thoroughly after taking care of a person who has a cold, cough or sore throat.[standardfirstaidtraining.com]
  • The treatment of an attack of croup must be left to the physician, but a mother can do much in the way of prevention.[chestofbooks.com]
  • Curtis has been on Flixotide Jnr. in the past but we found this didn't help his situation, so he is now on a slightly stronger preventative puffer called Seretide. Curtis also takes 6ml of Redipred at bedtime each night, as a preventative medicine.[mdjunction.com]

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