Differentiating croup from other diseases
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.
Overview
Croup must be differentiated from other upper respiratory diseases and conditions that cause airway obstruction around the larynx, as well as those that present similar symptoms to influenza.
Differentiating Croup from Other Diseases
Croup must be differentiated from other upper respiratory diseases and conditions that cause airway obstruction around the larynx:[1][2]
- epiglottitis
- foreign body obstruction
- subglottic stenosis
- angioneurotic edema
- retropharyngeal abscess
- bacterial tracheitis
The tables below summarize the differences between croup and other upper respiratory conditions with similar symptoms:
| Disease | Findings |
|---|---|
| Epiglottitis | Typically presents with fever, difficulty swallowing, dysphonia, drooling, and stridor. Can rapidly progress to include cyanosis and asphyxiation and is much more severe than croup; it is often an emergency requiring intubation.[3] |
| Subglottic stenosis | Presents with stridor and difficulty breathing; can be a life-threatening emergency requiring intubation to remove the airway obstruction.[4] |
| Bacterial tracheitis | Presents with barking cough, stridor, fever, chest pain, ear pain, difficulty breathing, headache, dizziness. Symptoms, particularly fever, are more severe than croup. Requires antibiotic treatment.[5] |
| Retropharyngeal abscess | Presents with neck pain, stiff neck, torticollis and may include enlarged cervical lymph nodes, fever, malaise, stridor, and barking cough. Requires tonsillectomy and use of antibiotics.[6] |
| Angioneurotic edema | Presents with swelling of the dermis, subcutaneous, mucosa and submucosal tissues. Can occur in the upper respiratory system and result in stridor and respiratory arrest, requiring emergency treatment. Acquired angioneurotic edema results from an allergic reaction and be treated with epinephrine.[7] |
References
- ↑ Everard ML (2009). "Acute bronchiolitis and croup". Pediatr. Clin. North Am. 56 (1): 119–33, x–xi. doi:10.1016/j.pcl.2008.10.007. PMID 19135584.
- ↑ Cherry JD (2008). "Clinical practice. Croup". N. Engl. J. Med. 358 (4): 384–91. doi:10.1056/NEJMcp072022. PMID 18216359.
- ↑ de Vries CJ, de Jongh E, Zwart S, van den Akker EH, Opstelten W (2015). "[Epiglottitis in adults in general practice: difficult to recognise and life-threatening]". Ned Tijdschr Geneeskd (in Dutch; Flemish). 159: A9061. PMID 26332815.
- ↑ "Subglottic Stenosis | Otolaryngology - Head and Neck Surgery | Baylor College of Medicine | Houston, Texas".
- ↑ Al-Mutairi B, Kirk V (2004). "Bacterial tracheitis in children: Approach to diagnosis and treatment". Paediatr Child Health. 9 (1): 25–30. PMC 2719512. PMID 19654977.
- ↑ Craig FW, Schunk JE (2003). "Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management". Pediatrics. 111 (6 Pt 1): 1394–8. PMID 12777558.
- ↑ Cicardi M, Zanichelli A (2010). "Acquired angioedema". Allergy Asthma Clin Immunol. 6 (1): 14. doi:10.1186/1710-1492-6-14. PMC 2925362. PMID 20667117.