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Recurrent croup presentation, diagnosis, and management.

Kelvin Kwong¹, Michael Hoa, James M Coticchia

¹Wayne State University School of Medicine, Detroit, MI 48201, USA.

American Journal of Otolaryngology

|November 6, 2007

Summary

Recurrent croup in children often indicates an underlying upper airway lesion, frequently subglottic stenosis due to gastroesophageal reflux. Early diagnosis via laryngoscopy and long-term reflux management are crucial for effective treatment.

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Area of Science:

Pediatric Otolaryngology
Gastroenterology
Respiratory Medicine

Background:

Recurrent croup is often misdiagnosed, delaying treatment for underlying upper airway lesions.
This study investigates the etiology, diagnosis, and outcomes of children with recurrent croup.

Observation:

A retrospective review of 17 children with recurrent croup was conducted.
Gastroesophageal reflux disease (GERD) was a common comorbidity, present in 35.3% initially and 82.3% endoscopically.
Laryngopharyngeal reflux lesions, predominantly subglottic, were observed in 82.3% of patients.

Findings:

All 17 patients (100%) exhibited subglottic stenosis, with 14 (82.3%) showing 30-70% narrowing (Cotton-Myer grade I-II).
Subglottic stenosis was the primary finding in all patients, often associated with GERD.

Implications:

Recurrent croup warrants prompt laryngoscopy/bronchoscopy to identify airway lesions.
Long-term follow-up and antireflux treatment are essential for managing GERD-related subglottic stenosis.
Endoscopic confirmation of reflux resolution is vital for treatment success.