Croup-like symptoms may be seen in several conditions. Failure to identify the cause of a child's illness can result in a delay in appropriate therapy with increase morbidity and mortality.


Infectious conditions with croup-like symptoms:

(1) epiglottitis

(2) laryngeal diphtheria

(3) retropharyngeal abscess

(4) peritonsillar abscess

(5) bacterial tracheitis


Causative bacteria may include:

(1) Hemophilus influenzae

(2) Streptococcus pneumonia

(3) Group A beta hemolytic Streptococcus and other species

(4) Staphylococcus aureus

(5) Moraxella catarrhalis

(6) Corynebacterium diphtheriae and related species


Noninfectious conditions with croup-like symptoms:

(1) foreign body aspiration (tracheal, esophageal)

(2) angioneurotic edema

(3) allergic reaction

(4) toxic inhalation


Reasons to consider one of these diagnoses:

(1) failure to respond to standard croup therapy

(2) fever

(3) toxic-like appearance

(4) outbreak or high prevalence of an infection in a population

(5) inadequate vaccination to diphtheria or Hemophilus influenzae

(6) history of a chewing or swallowing something just prior to onset

(7) sudden onset

(8) presence of urticaria or other signs of an allergic reaction

(9) non-barking cough


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