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Croup syndrome: historical perspective.

¹Department of Otolaryngology, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburg, PA 15213-3417.

The Pediatric Infectious Disease Journal

|November 1, 1988

Summary

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Acute croup syndrome management has evolved, distinguishing viral croup, bacterial tracheitis, and epiglottitis. Modern approaches favor intubation over tracheotomy for airway obstruction, though treatment for laryngotracheobronchitis remains debated.

Area of Science:

Pediatrics
Infectious Diseases
Otolaryngology

Background:

Acute croup syndrome historically encompassed various upper airway conditions.
Advancements in identifying bacterial and viral etiologies have led to distinct clinical classifications.

Observation:

Viral croup is common and self-limiting.
Bacterial tracheitis is rare and can be a complication of viral croup.
Epiglottitis is often caused by H. influenzae.

Findings:

Management of airway obstruction in children has shifted significantly.
Tracheotomy for epiglottitis has been largely replaced by intubation, which is considered safe.
Medical management is successful for most laryngotracheobronchitis cases, but intervention methods remain debated.

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Implications:

Improved diagnostic capabilities have refined the understanding and management of pediatric airway emergencies.
The shift towards less invasive procedures like intubation reflects advancements in pediatric critical care.
Ongoing debate highlights the need for further research into optimal treatments for complex cases of laryngotracheobronchitis.