A child has laryngotracheobronchitis. He presents with stridor. He should be treated with:
1.Endotracheal intubation
2.Antibiotics only
3.Elective tracheostomy
4.Immediate tracheostomy
sol:
Acute laryngotracheobronchitis or croup is an infection of the up-per and lower respiratory "tract that causes marked sub-glottic edema. Fever, hoarseness, a “seal’s bark” cough, and inspiratory stridor are the usual clinical, features. Most common etiological agent is parainfluenza virus, although it may also be caused by other viruses; (e.g., influenza or respiratory syncytial virus) and by Mycoplasma pneumoniae. As it is usually viral infection, chemotherapeutic agents are of no use and antibiotics are not indicated to prevent supra infection. Use of steroid remains controversial and efficacy is not proved. If there is respiratory obstruction the child should be intubated by passing an endotracheal tube. Tracheostomy should be done if intubation is required beyond 72 hours.