Croup vs Epiglottitis
Croup and Epiglottitis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Croup vs Epiglottitis at a glance
- Croup: Viral upper airway infection in young children causing barking cough and stridor.
- Epiglottitis: Life-threatening supraglottic bacterial infection with risk of complete airway obstruction.
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Side-by-side comparison
| Feature | Croup | Epiglottitis |
|---|---|---|
| At a glance | Viral upper airway infection in young children causing barking cough and stridor. | Life-threatening supraglottic bacterial infection with risk of complete airway obstruction. |
| Classic presentation | Prodrome 1-3 days: rhinorrhea, mild fever, cough; Classic triad: barking 'seal-like' cough, hoarseness, inspiratory stridor (worse with agitation, crying);… | Pediatric 'four D's': dysphagia, drooling, dyspnea, dysphonia, in a toxic-appearing child sitting in tripod position. Always consider in any adult with severe… |
| Workup / key labs | Generally clinical diagnosis — no labs required in classic presentation; Severe or atypical cases: viral PCR can identify pathogen; Pulse oximetry to assess… | Clinical suspicion based on presentation + visual confirmation by laryngoscopy in OR or controlled setting (cherry-red, edematous epiglottis).; Defer all… |
| Imaging | Imaging usually NOT needed; clinical diagnosis sufficient; AP neck radiograph (if obtained): 'steeple sign' — subglottic narrowing of tracheal air column… | Lateral neck soft-tissue radiograph (if patient stable): 'thumbprint sign' — enlarged, thickened epiglottis; specific but only obtain if it will not delay… |
| First-line treatment | Calm child — avoid agitation (worsens stridor); allow caregiver to hold; Humidified air or mist tents — historically used but lack evidence; comfort measure;… | Secure the airway is the priority — minimize handling, keep child calm with caregiver; Transport to OR or controlled environment with ENT and anesthesia for… |
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