Acute epiglottitis and severe croup. Experience in two English regions

The case histories of 50 children who required tracheal intubation for epiglottitis or croup in two English regions have been reviewed. The incidence of severe croup was different in the two regions. The presentation of epiglottitis was variable, and the correct diagnosis was frequently made only at laryngoscopy. Unexpected and rapid deterioration occurred in both diseases, and cyanosis was commonly present on hospital admission and at laryngoscopy. Two children required planned tracheostomy and there were two deaths. The principles of safe management are discussed.