Croup syndrome in children: five-year experience

Area of Science:

• Pediatrics
• Infectious Diseases
• Respiratory Medicine

Background:

• Croup syndrome is a common respiratory illness in children.
• Understanding the specific causes and clinical presentations is crucial for effective management.
• Distinguishing between viral and bacterial etiologies is essential for appropriate treatment.

Purpose of the Study:

• To investigate the etiology and clinical features of croup syndrome in hospitalized children.
• To identify the pathogens responsible for croup.
• To compare clinical characteristics between different causes of croup.

Main Methods:

• Retrospective review of clinical records of 132 children diagnosed with croup syndrome.
• Pathogen identification through various laboratory methods.
• Bronchoscopic examination for suspected bacterial tracheitis.
• Analysis of clinical data including fever duration and associated diagnoses.

Main Results:

• Laryngotracheobronchitis was the most common diagnosis (93.2%).
• Viral pathogens (parainfluenza, RSV, influenza A, adenovirus) and Mycoplasma pneumoniae were identified.
• Bacterial tracheitis was confirmed in 5.3% of cases.
• Prolonged fever (>3 days) was significantly associated with bacterial tracheitis and laryngotracheobronchitis with complications.
• Bacterial tracheitis was more common than epiglottitis in this Taiwanese cohort.

Conclusions:

• A longer duration of fever and severe airway obstruction in croup may indicate a bacterial cause or complication.
• Bacterial tracheitis is a notable cause of croup syndrome and is more prevalent than epiglottitis in Taiwan.
• Prompt recognition of potential bacterial involvement is important for timely intervention.