A toxic child with fever, stridor, and barky cough. May have hoarseness and often preceded by URI that is clinically not improving. No drooling and Staphylococcus aureus most common pathogen. Visualization of the trachea may demonstrate purulent material. Treatment nasotracheal intubation Antibiotics to cover Staph, Strep, and H. flu.
Stridor is accentuated by crying and being excited.
Try to evaluate the patient when they are quiet and relaxed to best judge difficulty of breathing. Often preceded by URI and symptoms may improve after emesis. In mild case increasing humidity may help Cold night air may relieve the symptoms. Parents should dress the child and take them outside and see if there is improvement. If the child is hypoxic or cyanotic, supplemental oxygen should be administered.