Croup: The Daily PANCE Blueprint
Which of the following is a common symptom associated with laryngotracheobronchitis (viral croup)?
A. drooling
B. high fever
C. "hot potato" voice
D. barking cough
Answer and topic summary
The answer is D. barking cough
Viral croup is characterized by a history of upper respiratory tract symptoms followed by the onset of a barking cough and stridor.
- Drooling and a “hot potato” voice are seen with epiglottitis, not viral croup.
- Fever is usually absent or low grade in patients with viral croup.
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Pearls
Croup refers to an infection of the upper airway, which obstructs breathing and causes a characteristic barking cough
- Caused by the parainfluenza virus
- Common in children 6 mo-3 yrs
- Fall and early winter months (same time of year as bronchiolitis)
- Barking cough and stridor
Diagnosis
In children with croup, a posterior-anterior chest radiograph demonstrates subglottic narrowing, commonly called the “steeple sign”
- Steeple sign = narrowing of the trachea in the subglottic region
Treatment
Supportive care includes humidified air or oxygen, antipyretics, and encouragement of fluid intake
- For children with moderate to severe croup: IV fluids, nebulized epinephrine and a single dose of glucocorticoid (dexamethasone)
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Pulmonary (10%) ⇒ ⇒
