1) Describe pt. history and symptom
2) Describe patient’s population affected , frequency
3) Advantage and disadvantage over other modalities
4) Describe of modality used including view , positioning , techniques.
5) Review of image findings( can include other supporting test such as lab, etc
6) Diagnosis and discussion of pathology
7) Treatment option
9) Reference( using APA format)
Croup is a viral or bacterial infection that affects the larynx, bronchial tubes and the trachea. The disease can spread from one person to another during the first days of sickness though direct inhalation from a cough and contact of eyes and mucus. It is characterized by dry and harsh cough that produces a sound like that of a barking seal. A patient also produces a raspy sound when breathing in and they may develop difficulty in breathing as the illness progresses because of the narrowing of the air passage. While severe croup is life threatening, proper early treatment may cure it within 3 to 7 days.
History and Symptoms
Croup was known in the 18th century and in 1826 viral croup which is more prevalent was distinguished from bacterial croup. In 1990, community acquired adult croup was identified. Symptoms include sore throat, cough, frequent runny nose and low grade fever that may exceed 40 degrees Celsius. After 2 days, the patient begins to produce a barking cough and a harsh sound when breathing and develops difficulty in breathing, symptoms that last for about one to two weeks. One can develop recurrent croup which becomes worse at night with upper respiratory pains (Mintz & Spencer, 2006). They may also develop gastro esophageal reflux disease, GERD, symptoms such as a burning feeling in the chest and throat, pain in the chest, dry cough, acid reflux and sore throat.
Croup mostly affects children between ages of 5 months and 6 years and in rare cases it affects children of up to 15 years of age and adults. It affects males more than females and is fatal in infants. It affects about 5% of children every year and about 75% of these infections are viral (Mintz & Spencer, 2006). It also has a recurrence rate of 5%. Croup may be mild or severe although severe cases are rare.
Modalities used in treating croup include moist air with supplemental oxygen, epinephrine medication and corticosteroids. Moist air reduces mucosal edema and also reduces the thickness of mucous making its removal from the airway easy. Epinephrine is important for reversing the narrowing of the airway. Steroids are administered in severe cases of croup to reverse the airway obstruction (Mintz & Spencer, 2006). Treatment with steroids is more advantageous than the other treatments because mist air and epinephrine have not been proven to be effective and their use requires further studies.
Viewing and positioning techniques
Pulse oximetry is used in diagnosing croup if the patient also has bronchiolitis or pneumonia. Support techniques may include laryngoscopy and airway support to study the back of the throat and larynx. Nasopharyngoscopy may also be used in examining the glottic and supraglottic areas. In laryngotracheobronchitis cases, endoscopy may be done (Grimm, 2016). To review the image findings, neck radiographs are important and are used in evaluating if stridor is caused by croup infection or other causes.Direct visualization of the epiglottis must alsobe done by an expert to correctly distinguish croup from epiglottitis.
Diagnosis and Pathology
A research tool for evaluating the severity of the disease and accessing response to treatment has been developed by Westley and associates It is important to monitor the illness by doing frequent physical examinations. Viral croup is caused by parainfluenza and influenza viruses while bacterial croup is caused by diphtheria bacterium (Mintz & Spencer, 2006).
Mild croup is treated at home with painkillers and a dose of corticosteroids will be helpful. Severe cases should be treated in hospitals with adrenaline and corticosteroids and hospitalization may be needed.
If a patient is given proper treatment, the illness goes away within 3-7 days. However, if it leads to epiglottitis and tracheitis, it may be fatal (Mintz & Spencer, 2006).
Croup affects the larynx, bronchial tubes and the trachea and is more common
is male children than in female ones. Severe cases lead to epiglottitis and
tracheitis and may lead to death. Treatments include epinephrineand
corticosteroids administration and inhalation of humid air. Viewing and
supporting techniques may include pulse oxymetry,
laryngoscopy, nasopharyngoscopy and endoscopy.
Grimm, L. (2016). Imaging in Croup: Overview, Radiography. Emedicine.medscape.com. Retrieved 8 February 2017, from http://emedicine.medscape.com/article/407964-overview
Spencer, J., & Mintz, M. L. (2006). 9 Croup. In Disorders of the Respiratory Tract: Common Challenges in Primary Care (pp103-113). Totowa: Humana Press. Retrieved from http://eknygos.lsmuni.lt/springer/621/103-113.pdf