Complete respiratory obstruction can occur within hours of the onset of symptoms. Examination with a tongue blade or indirect laryngoscopy may cause coughing or gagging which can precipitate sudden total airway obstruction, and should only be attempted by an experienced examiner with tracheotomy instruments immediately at hand. Treatment - Prompt attention is mandatory, and management of the airway is of paramount importance when epiglottitis is diagnosed. The patient should be taken to the operating room for examination and an airway established either by endotracheal intubation or tracheotomy. Once the airway is secured, the larynx can be examined more carefully.
Blood cultures are the most reliable means of obtaining a culture of the offending organism.
This is a subglottic and tracheobronchial inflammatory process most commonly caused by parainfluenza, respiratory syncytial and other viruses, with circumferential subglottic erythema and edema. Symptoms - Upper airway obstruction with a barking cough. The disease most commonly occurs in children between six months and two years of age. Viral croup is preceded by an upper respiratory infection with sore throat. Signs - A characteristic croupy cough, stridor, hoarse voice and tracheobronchial secretions.