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Pediatrics JIPMER 2018 8f905234

Steeple sign is seen in?

A
Influenza infection
B
Croup
C
Laryngomalacia
D
Acute epiglottitis
High-Yield Explanation
Due to narrowing of the airway it resembles the steeple of the church. It is a characteric x ray finding for croup/ acute laryngo tracheo bronchitis. Croup is a viral infection, most common causative agent is parainfluenza virus C/F fever, malaise, respiratory distress, barking cough, stridor Rx: Mild case Dexamethasone i/m single dose Mild- moderate Dexamethasone single dose + nebulized epinephrine, suppoive care No role of antibiotics Acute epiglottitis shows thumb sign On direct inspection we see cherry red epiglottis (red swollen epiglottis). Most common causative agent is streptococcus (previously it was H. influenzas but with availability of H. influenzae vaccine, it is streptococcus) It is bacterial infection for the child is much more sick C/F High grade fever, drooling of saliva, respiratory distress Rx along with respiratory suppo we give antibiotics Treatment of choice-> IV 3 generation Cephalosporins Ceftriaxone

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