title: Diagnostic and therapeutic efficiency in croup and epiglottitis.
abstract: 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: WBC over 15,000 with more than 10 stabs, WBC over 20,000, or WBC with more than 20 stabs. Ampicillin resistant 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.
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001784:Blood Gas Analysis; D002675:Child, Preschool; D003378:Counterimmunoelectrophoresis; D003440:Croup / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D004826:Epiglottitis / Q000175:diagnosis* / Q000628:therapy; D006192:Haemophilus Infections / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D007827:Laryngitis / Q000175:diagnosis*; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents