II. Epidemiology
- Affects older children than in croup (ages 1-8 years)
III. Pathophysiology
- Secondary infection of viral Upper Respiratory Infection (e.g. croup)
IV. Causes
V. Symptoms
VI. Signs
- Toxic appearance
- High Fever
- Difficulty controlling secretions (Drooling, unable to swallow)
- Purulent airway secretions
- Respiratory distress
- Does not respond to Croup therapies
- Unresponsive to Racemic Epinephrine or mist therapy
VII. Differential Diagnosis
VIII. Imaging
- Lateral Neck Xray
- Tracheal pseudomembrane
- Necrotic epithelium subdivides trachea lumen
- Bronchoscopy
- Tracheal pseudomembranes
- Purulent secretions
IX. Management
- Keep patient calm (same tenets for croup, Epiglottitis, Foreign Body Aspiration)
- Endotracheal Intubation
- Emergent management
- Broad Spectrum Antibiotics including coverage for MRSA
- Antibiotics are similar to those for Epiglottitis
- Example: Vancomycin and Ceftriaxone
X. References
- Dahan, Campbell and Melville (2020) Crit Dec Emerg Med 34(11): 3-10