Thumb sign is seen in:
Correct Answer: Epiglottitis
Description: Ans: D (Epiglottitis) . Diagnosis Of Acute Epiglottitis Diagnosis is usually based purely on history & clinical finding. Lateral soft tissue radiograph may reveal the classic Thumb sign of edematous epiglottis with a dilated hypopharynx. Transnasal fiberoptic laryngoscopy is most reliable & most commonly used the technique to assess resolution of edema before extubation of tube in acute epiglottitis"- Baiienger's otolaryngology Direct laryngoscopy is the most important laryngeal investigation in general. It permits a dose examination of laryngeal & pharyngeal structures" - LT 10th/l54 Differences between acute epiglottitis and acute laryngo-tracheobronchitis in children Acute epiglottitis Acute laryngo-tracheobronchitis (or croup) Common Causative organism Strep. pneumonia Parainfluenza virus type I and II Age 2-7 years 3 months to 3 years Pathology Supraglottic larynx Subglottic area Prodromal symptoms Absent Present Onset Sudden Slow Fever High Low grade or no fever Patient's look Toxic Non-toxic Cough Usually absent15 Present(Barkingseal-like) Stridor Present and may be marked Present Odynophagia Present with drooling of secretions Usually absent Radiology Thumb sign on lateral view5 Steeple sign on anteroposterior view of neck' Treatment Humidified oxygen, a third generation cephalosporin (ceftriaxone) or amoxicillin Humidified O2 tent, steroids
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