| Croup |
- Parainfluenza virus most common cause
- Edema of subglottis and proximal trachea
- Barky 'seal-like' cough
- Inspiratory stridor worsening when crying
- Steeple sign on AP neck X-ray
- Cool mist + racemic epinephrine + dexamethasone
- Typically 6 months–3 years
|
| Epiglottitis |
- H. influenzae type b historically (now rare due to Hib vaccine)
- Edema of epiglottis + aryepiglottic folds
- Tripod posturing, drooling, toxic appearance
- Inspiratory stridor + muffled 'hot potato' voice
- Thumb sign on lateral neck X-ray
- Immediate airway management in OR (do NOT examine throat first)
|
| Bronchiolitis |
- RSV most common cause
- Inflammation and mucus plugging of small airways
- Expiratory wheeze + crackles (not stridor)
- Typically <2 years
- Nasal flaring + subcostal retractions
- Supportive management only; no routine bronchodilators
|
| Foreign Body Aspiration |
- Sudden onset without prodrome
- Unilateral wheeze or unilateral decreased breath sounds
- Air trapping → hyperinflation on expiratory X-ray
- Rigid bronchoscopy for removal
- Most common in 1–3 years (peanuts, grapes)
|