| Name | Definition | Age Group | Etiology | Assessment: Definitive Clinical Signs and Symptoms | Plan: Specifics of Treatment | Prognosis |
|---|
| Upper Airway Infections |
| Croup (acute spasmodic laryngitis) | Paroxysmal attacks (spasms of larynx) | 3 months–3 years | Viral (possible allergy or psychogenic) | - Most common onset at night
- Inspiratory stridor
- “Croupy” barking cough
- Dyspnea
- Anxiety
| - Teach parents—turn on hot water in bathroom and close door (steam); warm temperature will not relieve the congestion
- Common to treat at home
| Excellent (but likely to recur) |
| Epiglottitis | Extremely acute, severe, and rapid, progressive swelling (due to infection) of epiglottis and surrounding tissue | 1–8 years | Bacterial ( H. influenzae type b) | - Abrupt onset—rapid progression; medical emergency
- Dyspnea
- Dysphagia
- Sit up/chin thrust/mouth open
- Thick muffled voice
- Cherry red, swollen epiglottis
| - Do not visualize epiglottis unless airway support is immediately available
- Will need endotracheal tube or tracheostomy for 24–48 hr to maintain patent airway
 IV ampicillin for 10–14 days to treat bacterial infection
IV corticosteroids (e.g., Solu-Cortef) to reduce inflammation
| Very good if detected and treated early
Prevent via Hib immunization |
| Laryngotracheobronchitis (LTB) | Acute infection of lower respiratory tract: larynx, trachea, and bronchi | 3 months– 8 years | Viral (possible secondary bacterial infection) | - Inspiratory stridor
- High fever
- Signs and symptoms of severe respiratory distress
- Hoarseness, progressing to aphonia and respiratory arrest without treatment
| Hospitalization:
- Tracheostomy set at bedside
- Racemic epinephrine/steroids
- Antibiotics if cultures are positive
| Good |
| Lower Airway Infection |
| Bronchiolitis/respiratory syncytial virus (RSV) | Acute viral infection of lower respiratory tract (small, low bronchioles), with resultant trapping of air | Infants 2–12 months (peak at 2–5 months) | Respiratory syncytial virus 80% of cases | - Hyperinflation of alveoli
- Scattered areas of atelectasis
- Acute, severe respiratory distress for first 48–72 hours, followed by rapid recovery
| Supportive care during acute phase:
- Hospitalization
- High humidity
- Oxygen
 IV fluids- Clear liquids
- Ribavirin (not given everywhere)
- RespiGam or Synagis may be given as prophylaxis
| Excellent (less than 1% mortality rate) |