A. i.e. (Larynx) (717-B&L 25th)LARYNGOTRACHEO BRONCHITIS (CROUP)* Most commonly in children under 2 years of age* Usually viral in origin* The children have biphasic stridor and are often hoarse with a typical barking cough* Air way intervention is required less oftenAcute epiglottitis - Stridor is usually associated with drooling of salivaDifferences between acute epiglottitis and acute larybngo-tracheo bronchitis in children (267-Dhingra 4th) Acute epiglottitis(Supraglottic Laryngitis)Acute laryngotracheobronchitis* Causative organismH. influenzae type BPara influenza virus type I & II* Age2-7 years3 months to 3 years* PathologySupraglottic larynxSub glottic area* Prodromal symptomsAbsentPresent* OnsetSuddenSlow* FeverHighLow grade or no fever* Patients's lookToxicNon - Toxic* CoughUsually absentPresent (Barking seal like)* OdynophagiaPresent with drooling of secretionsUsually absent* StridorPresent and may be markedPresent* Radiology"Thumb sign" on lateral viewSteeple sign on AP view of neck* TreatmentHumidified oxygen, third generation cephalosporins (Ceftriaxone) or amoxicilline)Humidified oxygen tent, steroids.* LARYNGEAL DIPHTHERIA* Very toxaemic with tachycardia and thready pulse* **Hoarse voice, croupy cough. Inspiratory stridor, increasing dyspnoea wth marked upper airway obstruction* **Greyish white membrane is seen in the tonsil, pharynx and soft palate* "Bull-neck" cervical lymphadenopathyComplications Asphyxia and death due to airways obstruction. Toxic myocarditis and circulatory failure, palatal paralysis with nasal regurgitation, Laryngeal and pharyngeal paralysis.