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A fully immunized 2 yo boy presents to the ER with several days of low-grade fever, barking cough and noisy breathing. Over the last few hours he has developed a fever to 40°C and looks toxic. He has inspiratory and expiratory stridor. The family has not noticed drooling and he seems drinking without pain. Direct laringoscopy reveals a normal epiglottis. The management of this disease process includes:

A. intubation and IV antibiotics

B. Inhaled epinephrine and oral steroids

C Inhaled steroids

D. Obsrevation only

E. Oral antibiotics and outpatient follow-up

Edited by virgola82 on May 23, 2007 - 10:42 PM


E. Oral antibiotics and out patient follow up


Actually the right answer is A.

This pt has bacterial tracheitis as a sequella of viral laryngotracheobrochitis. Its typical prsentation is with several days of URI followed by acute spiking fever and resp distress. It's not epiglottitis because of absent drooling and dysphagia. Management include establishment of an airway through intubation and IV antibiotics.

I got it wrong too when I did it...


Thanks, well i atleast got it till tracheitis but not the management.
Keep the questions coming.

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