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Endoscopic
Deep
red
mucosa
Cherry
red
epiglottis
Deep
red
mucosa
Pale
mucosa
findings
Subglottic
narrowing
Ary-‐epiglottic
swelling
Copious
secretions
Subglottic
narrowing
WBC
Normal
/
Leucopenia
Leukocytosis
with
Leukocytosis
with
left
Normal
left
shift
shift
Racemic
Intubation
Cool
mist
Epinephrine
Steroids
Intubation
Treatment
Antibiotics
(sudden
symptoms
recur
for
Cool
mist
Antibiotics
2-‐3
nights)
Tracheal
suctioning
Prognosis
Excellent
Excellent
with
proper
Excellent
Excellent
treatment
Prevention
Flu
vaccine
HIB
vaccine
None
None
2
Module 3: Pulmonology Pediatrics II
Lecture 1: Upper Airway Obstruction ZPY2017
Dr. Olivia Go
PPT/emphasized Additional Notes/Nelson
EPIGLOTTITIS
*If
you
want
to
inspect
the
throat:
Double
set-‐up
à
OR
+
Anesthesiologist
à
to
prepare
for
intubation/tracheostomy
as
needed
*Radiology:
Lateral
X-‐ray
view
but
may
cause
asphyxia
(prepare
double
set-‐up)
Croup
Syndrome
Differential
Diagnosis
Feature
Peritonsillar
abscess
Retropharyngeal
Foreign
body
Angioneurotic
edema
abscess
<4
y/o
Age
>10
y/o
(younger
–
increase
in
Any
age
group
Any
age
group
lymphnode
tissues)
Group
A
Group
A
Etiology
Streptococcus
Streptococcus
S.
Small
objects
C1
esterase
deficiency
aureus
Anaerobes
Anaerobes
Location
Oropharynx
Posterior
pharynx
Variable
Variable
Biphasic
illness
Insidious
to
Onset
(first,
tonsillitis)
then,
Sudden
Sudden
sudden
worsening
sudden
Trismus
Thickened
(spasm
of
the
jaw
muscles)
retropharyngeal
Radiographic
(displaced
uvula;
space
Radioopaque
Subglottic
narrowing
findings
asymmetric
(posterior
object
tonsilar
bulge)
pharyngeal
bulge;
neck
stiffness)
WBC
Leucocytosis
w/
Leucocytosis
w/
Normal
Normal
left
shift
left
shift
Endoscopic
Tonsillar
abscess
Retropharyngeal
Foreign
body
Supra
and
subglottic
findings
mass/bulge
swelling
Antibiotics
Treatment
Antibiotics
Incision
and
Endoscopic
Epinephrine
Aspiration
drainage
removal
Steroids
(Trendelenberg
position)
4