Summary
Definition
History and exam
Key diagnostic factors
- sintomas que aumentam com agitação
- tosse ladrante tipo "latido de foca" distinta
- 6 meses a 6 anos de idade
Other diagnostic factors
- sexo masculino
- intensidade máxima no final do outono
- sintomas prodrômicos
- início abrupto dos sintomas
- os sintomas pioram à noite
- rouquidão
- dificuldade respiratória (retração esternal/intercostal, estridor)
- agitação persistente
- letargia
- movimento assíncrono da parede torácica e abdominal
- fadiga
- sinais de hipóxia (palidez ou cianose)
- sinais de hipercapnia (diminuição do nível de consciência em decorrência do aumento de PaCO₂)
Risk factors
- 6 meses a 6 anos de idade
- sexo masculino
- intubação prévia
Diagnostic tests
1st tests to order
- exame clínico
Tests to consider
- radiografia anteroposterior e lateral do pescoço
Treatment algorithm
leve (sem estridor em repouso)
moderado (estridor em repouso; sem agitação ou letargia)
grave (estridor em repouso com agitação ou letargia)
Contributors
Authors
Candice Bjornson, MSc, MD, FRCPC
Associate Professor
University of Calgary
Calgary
Canada
Disclosures
CB declares that she has no competing interests. CB is the author of several references in this topic.
David Johnson, MD
Professor
Department of Pediatrics and Physiology and Pharmacology
University of Calgary
Calgary
Canada
Disclosures
DJ declares that he has no competing interests. DJ is the author of several references in this topic.
Peer reviewers
Ken Farion, MD
Assistant Professor
Pediatrics and Emergency Medicine
University of Ottawa
Ottawa
Canada
Divulgaciones
KF declares that he has no competing interests.
Doreen Matsui, MD, FRCPC
Associate Professor
Departments of Paediatrics and Medicine
Children's Hospital of Western Ontario
London
Ontario
Canada
Divulgaciones
DM declares that she has no competing interests.
Jeremy Hull, MBBS
Consultant Paediatrician
Children's Hospital and West Wing
John Radcliffe Hospital
Oxford
UK
Divulgaciones
JH declares that he has no competing interests.
Steve Cunningham, MBBS, PhD
Consultant Respiratory Paediatrician
Department of Respiratory & Sleep Medicine
Royal Hospital for Sick Children
Edinburgh
UK
Divulgaciones
SC declares that he has no competing interests.
Donna J. Lee, MD
Pediatric Pulmonology
Joseph M. Sanzari Children's Hospital,
Hackensack Meridian Health
Hackensack
NJ
Divulgaciones
DL declares that he has no competing interests.
Deepak Mehta, MD, FRCS ( Oto)
Professor of Otolaryngology
Director Pediatric Aerodigestive Center,
Baylor College of Medicine,
Texas Children’s Hospital,
Houston
TX
Divulgaciones
DM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Johnson D, Klassen T, Kellner J. Diagnosis and management of croup: Alberta Medical Association clinical practice guidelines. Alberta: Alberta Medical Association; 2015 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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