Difference between Epiglottitis and Croup
Comparison of Laryngotracheobronchitis (CROUP) and Epiglotitis
|Causative organism||Usually viral||Usually pneumococci or streptococci|
|Usual age of child||6 months to 3 years||3 years to 6 years|
|Seasonal occurrence||Late fall and winter||None|
|Onset pattern||Preceded by upper respiratory infection||Preceded by upper respiratory infection; suddenly very ill|
|Presence of fever||Low grade||Elevated to about 103 degree F|
|Appearance||Retractions and stridor; prolonged inspiratory phase of respirations; not very ill-appearing||Drooling; very-ill appearing, neck hyperextended to breathe|
|Radiographic findings||Lateral neck radiograoh showing subglottal narrowing||Lateral neck radiograph showing elraged epiglottis|
|Possible complications||Asphyxia due to subglottic obstruction||Asphyxia due to supraglottic obstruction|
Source: Maternal and Child Health Nursing: Care of the Childbearing and Childbreaing Family by Pillitteri , 5th Ed.
Detailed Information of Epiglottitis and Croup
The epiglottis is a flap of tissue covering the opening of the larynx to keep out the food and fluid from entering the respiratory tract. Epiglottitis is the inflammation and the infection of the epiglottis. It is a rare case, however, epiglottitis is an emergency condition as the swollen epiglottis cannot rise and allow the airway to open.
- The inflammation of epiglottitis occurs most frequently in children from 2 to about 7 years of age.
Signs and Symptoms
- Severe inspiratory stridor
- High fever
- Hoarseness or voice
- Sore throat
- Difficulty swallowing or dysphagia
- Tongue protrusion to increase free movement in the pharynx
- Throat – seen as a cherry-red structure and edematous
- Muffled cough
- Cyanosis – severe cases
- To reduce epiglottal inflammation, moist air is needed.
- Oxygen if cyanosis is present.
- Antibiotic therapy such as a second-generation cephalosporin – CEFUROXIME may be prescribed until throat culture indicates a specific antibiotic drug. Cefuroxime may be given for a full 7-10 days. After the antibiotic therapy is initiated, the epiglottal inflammation receded rapidly.
- To maintain hydration in patients with epiglotitis, intravenous fluid therapy is needed since these children cannot swallow.
- It is important that the nurse should prepare a tracheostomy or endotracheal intubation set at the bedside. Children with epiglotitis may need a prophylactic tracheostomy or necessitate endotracheal intubation to prevent total airway obstruction.
- IMPORTANT REMINDER: Never attempt to visualize the epiglottis directly with a tongue depressor because the gagging procedure causes complete obstruction of the glottis and results to respiratory failure.
- Throat culture should NOT be done UNLESS a means of providing an artificial airway such as a tracheostomy or endotracheal intubaton is readily available.