Croup (comparison with acute epiglotittis)
feature | epiglottitis | croup |
|---|---|---|
organism | H. influenzae | parainfluenza virus |
age | generally 2-6 years old, may occur in older children and adults | generally less than 2 years old, may occur in children 6 months to 6 years |
onset | rapid | gradual |
site | supraglottic | subglottic |
temperature | high fever | low grade fever |
dysphagia | severe | absent (mild) |
dispnoea | +++ | variable |
drooling | present | not present |
stridor | inspiratory or expiratory | mainly inspiratory |
lymph nodes | +++ | + |
cough | not common | barking cough |
voice | muffled | hoarse |
posture | sitting forward | lying down |
behaviour | quiet; terrified | struggling |
colour | grey | pink |
X-ray | thumb sign (+) | steeple sign (+) |
previous attack | none | may have had previous attack |
Note :
- thumb sign - enlarged round epiglottis which looks like a thumb print
- steeple sign - see investigations (croup)
Children with epiglottitis rarely have a cough, which may help to distinguish it from laryngotracheobronchitis or 'croup' (1)
Reference
- Glynn F, Fenton JE; Diagnosis and management of supraglottitis (epiglottitis). Curr Infect Dis Rep. 2008 May;10(3):200-4.
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