Clinical features

Possible clinical features include:

• usually occurs in a child aged 2 years old or less; by comparison, acute epiglottitis is normally seen in children between 2 and 6 years old
• may have a previous history of croup
• the condition is slow onset - acute epiglottitis is of fast onset
• stridor - generally inspiratory; may be biphasic
• barking cough or "croupy" cough
• no dysphagia - usually present in acute epiglottitis
• increased temperature
• child lying down - not upright as in acute epiglottitis
• the child has a hoarse voice
• dyspnoea - variable
• pink colour
• the child is struggling - not quiet as in acute epiglottitis
• symptoms worsens at night
  • peak between 24 and 48 hours
  • usually resolves within 7 days.
• agitation and crying aggravates symptoms
• children feel comfortable in the upright posture or when they sit up

Reference:

• (1) Doug Knutson, Viral Croup, Am Fam Physician, 2004;69:535-40,541-2