Epiglottitis Croup Spasmotic Croup Foreign
Age 3-7 yrs. 6 mos - 
3 yrs
1-5 yrs 6 mos-
7 yrs
Pathogen Bacterial 
H influenza type B
Parainfluenza, RSV
none necessarily Food 
Season not seasonable fall & winter  ---  ---
Onset rapid  (2-12 hrs.) gradual (24 - 72 hrs) preceded by UTI for several days   Abrupt (few minutes). Not UTI hx. necessarily Acute
Temperature 102 - 107 degrees F, increased WBC 98.6-101 degrees F  no fever necessarily none necessarily
Inflamation epiglottis, red supraglottic, 
cherry red large epiglottis
larynx, trachea larynx, trachea may sweel around object
Sign & Symptom sitting up, leaning forward. Mouth open, chin forward, neck extended. Sore throat drooling muffled voice anxious(appears extremely ill) Resp. Distress: marked inspir stridor, no cough, dec. BS, retractions (maybe) Cyanosis/palor (maybe)  seal-like barking cough,
stridor & hoarseness
seal-like barking cough,
stridor & hoarseness
Wheezing rarely
stridor, cough, 
may have; wheeze, dysphagia, cyanosis,
antibiotic ampicillin,
none none  for secondary infection
X-ray Supraglottic swelling. enlarged epiglottis.  Thumb sign (laateral neck) subglottic narrowing, steeple (hourglass) sign steeple sign object may or may not be visible
Treatment intubate with tracheostomy surgeon
humidity, racemic epinephrine,
steroids, intubation 5%
alergen avoidance bronchoscopy
object removal