Nelson Textbook of Pediatrics 22nd Edition | Croup (laryngotracheobronchitis): parainfluenza, barking cough, inspiratory stridor, steeple sign, treatment with dexamethasone ± racemic epinephrine. Epiglottitis (supraglottitis): Hib (vaccine rare), toxic, drooling, tripod, thumb sign, airway emergency. Bacterial tracheitis: S. aureus, high fever, toxic, pseudomembranes, requires intubation + IV antibiotics.
🌐 paeds.online — Pakistan's Pediatric Platform| Condition | First-line Treatment | Severe/Refractory |
|---|---|---|
| Croup (viral laryngotracheobronchitis) | Oral dexamethasone 0.6 mg/kg | Racemic epinephrine, admit if stridor at rest after epinephrine |
| Spasmodic croup (recurrent) | Oral dexamethasone | Evaluate for GERD, subglottic stenosis |
| Epiglottitis (supraglottitis) | Secure airway in OR (intubation), IV ceftriaxone + vancomycin | Tracheostomy if intubation fails |
| Bacterial tracheitis | Secure airway (intubation), IV vancomycin + third-gen cephalosporin | Rigid bronchoscopy for pseudomembranes |