18 months old child presents with low grade fever, stridor and barking cough. His chest x-ray was taken and given below. The line of treatment is
**Question:** 18 months old child presents with low grade fever, stridor and barking cough. His chest x-ray was taken and given below. The line of treatment is
A. Antibiotics
B. Bronchodilator
C. Steroids
D. Oxygen therapy
**Core Concept:**
The clinical scenario involves a 18 months old child presenting with low grade fever, stridor, and barking cough. Stridor is a high-pitched, whistling sound heard on auscultation of the neck. The barking cough is a nonproductive cough that sounds like a barking dog. These symptoms suggest a respiratory tract infection, likely involving the upper airway.
**Why the Correct Answer is Right:**
In this case, the correct answer is **D. Oxygen therapy** because the child is presenting with a respiratory distress, which includes stridor and barking cough, and low-grade fever. These symptoms indicate respiratory insufficiency due to infection or inflammation. Oxygen therapy helps in improving oxygen saturation and alleviating respiratory distress, which is essential to manage the child's condition.
**Why Each Wrong Option is Incorrect:**
A. **Antibiotics (Option A):** While antibiotics are essential in treating bacterial infections, the symptoms described are more consistent with a viral infection, which typically does not respond to antibiotics.
B. **Bronchodilator (Option B):** Bronchodilators are indicated for bronchoconstriction caused by asthma or other airway hyperresponsiveness conditions. In this case, the child's symptoms are more consistent with respiratory tract infection and are not due to airway hyperresponsiveness.
C. **Steroids (Option C):** Steroids are used to reduce inflammation in various medical conditions, but in this case, the symptoms are due to respiratory distress caused by infection or inflammation, not due to inflammation.
**Clinical Pearl:**
In paediatrics, a barking cough and stridor should alert the clinician to consider the possibility of respiratory distress due to viral respiratory tract infections, particularly in the context of a young child. It is essential to initiate supportive measures like oxygen therapy first, followed by appropriate antibiotic therapy once the causative organism is identified.