Nelson Textbook of Pediatrics 22nd Edition | Croup (laryngotracheobronchitis): viral (parainfluenza), barking cough, inspiratory stridor, steeple sign, treat with dexamethasone ± racemic epinephrine. Epiglottitis: medical emergency (Hib, now rare), toxic appearance, drooling, thumb sign, secure airway. 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 (single dose) | Racemic epinephrine, admit if stridor at rest after epinephrine |
| Spasmodic croup (recurrent) | Oral dexamethasone, mist | Rule out GERD, anatomic causes |
| Epiglottitis | Secure airway in OR (intubation), IV ceftriaxone + vancomycin | Tracheostomy if intubation fails |
| Bacterial tracheitis | Secure airway (intubation), IV vancomycin + third-gen cephalosporin | Frequent suctioning, bronchoscopy for pseudomembranes |