| Name | Definition | Age Group | Etiology | Assessment: Definitive Clinical Signs and Symptoms | Plan: Specifics of Treatment | Prognosis |
| Bronchiolitis/ respiratory syncytial virus (RSV) | Acute viral infection of lower respiratory tract (small, low bronchioles), with resultant trapping of air | Infants 2-12 mo (peak at 2-5 mo) | Respiratory syncytial virus |
Hyperinflation of alveoli Scattered areas of atelectasis Acute, severe respiratory distress for first 48-72 hr, followed by rapid recovery |
Supportive care during acute phase:
|
Excellent (less than 1% mortality rate) |
| Croup (acute spasmodic laryngitis) | Paroxysmal attacks (spasms of larynx) | 6 mo-3 yr | Viral (possible allergy or psychogenic) |
Most common onset at night Inspiratory stridor
"Croupy" barking cough Dyspnea Anxiety |
Teach parents - turn on hot water in bathroom and close door (steam)
|
Excellent (but likely to recur) |
| Laryngotracheobronchitis (LTB) | Acute infection of lower respiratory tract: larynx, trachea, and bronchi | Children less than 5 yr | Viral (possible secondary bacterial infection) |
Inspiratory stridor
High fever
Signs and symptoms of severe respiratory distress
Hoarseness, progressing to aphonia and respiratory arrest without treatment |
Hospitalization:
|
Good |
| Epiglottitis | Extremely acute, severe, and rapid, progressive swelling (due to infection) of epiglottis and surrounding tissue | 2-5 yr | Bacterial (H. influenzae type b) |
Abrupt onset - rapid progression; medical emergency
Dyspnea, dysphagia Sit up/chin thrust/mouth open Thick muffled voice Cherry red. swollen epiglottis |
Do
not
visualize epiglottis unless airway support is immediately available
Will need endotracheal tube or tracheostomy for 24 - 18 hr to maintain patent airway IV ampicilin for 10-14 days to treat bacterial infection IV corticosteroids (e.g., Solu-Cortef) to reduce inflammation |
Very good if detected and treated early
Prevent via Hib immunization |