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Diagnostic and therapeutic efficiency in croup and epiglottitis
Author(s) -
Hodge Kenneth M.,
Ganzel Toni M.
Publication year - 1987
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198705000-00017
Subject(s) - croup , medicine , epiglottitis , intensive care medicine , intubation , white blood cell , pediatrics , retrospective cohort study , surgery
Croup and epiglottitis continue to be potentially life‐threatening diseases in children. Early distinction is imperative as definitive treatment differs significantly. To determine the correlation of various clinical features, x‐rays, and laboratory tests with diagnosis and management planning, a retrospective chart analysis of 194 children with croup (N=169) and epiglottitis (N=25) was performed. The clinical history and physical findings were most important in differential diagnosis. Patient age, lateral neck x‐ray, and white blood count (WBC) strongly correlated with diagnosis. Counter immunoelectrophoresis (CIE) results did not alter therapy. No blood cultures were positive unless the patient had: 1. WBC over 15,000 with more than 10 stabs, 2. WBC over 20,000, or 3. WBC with more than 20 stabs. Ampicillin resistent H. influenzae occurred in 21% of positive blood cultures. Capillary blood gases did not correlate with clinical need for intubation. It is suggested that a selective evaluation of patients with epiglottitis and croup can be performed in a more cost‐effective manner without sacrifice in patient care.