Epiglottitis vs. Croup (Laryngotracheobronchitis)
Distinguishing these two causes of upper airway obstruction is a crucial emergency medicine and pediatrics skill for NEET PG.
| Feature | Croup | Epiglottitis |
|---|---|---|
| Etiology | Parainfluenza virus. | Haemophilus influenzae type b (Hib). |
| Onset | Gradual, “barking” cough. | Rapid/Sudden, high fever, drooling. |
| Clinical Position | Variable. | Tripod position, sniffing position. |
| Imaging Finding | Steeple sign. | Thumbprint sign. |
Management Pearls
- Croup: Managed with humidified air, corticosteroids (dexamethasone), and nebulized epinephrine if severe.
- Epiglottitis: DO NOT examine the throat without airway support; it can precipitate complete obstruction. Secure the airway immediately.
NEET PG Hint: If a question mentions a child who is “drooling” and sitting in a “tripod position,” think Epiglottitis immediately. If they have a “barking cough” and a “steeple sign” on X-ray, it is Croup. Remember that vaccination against Hib has significantly reduced the incidence of epiglottitis.