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PEDIATRICS

TREATMENT

■ Supplemental humidified O 2 and cool mist is commonly used but has not

been shown to improve outcomes.

■ Steroids in the form of one dose of dexamethasone lead to faster recovery.

Oral route has been shown to be as effective as IM injections.

■ Epinephrine nebs (if patient has stridor at rest or stridor with significant

respiratory distress)

COMPLICATIONS

■ Upper airway obstruction

■ Dehydration

PERTUSSIS

Known as “whooping cough,”this lower respiratory tract infection is caused

byBordetella pertussis(Gram-negative coccobacillus).

SYMPTOMS/EXAM

Clinically, pertussis is an illness lasting longer than 2 weeks, with paroxysms

of coughing (spasms or fits of multiple coughs in a row), followed by an inspi-

ratory whoop and often with associated posttussive emesis. There are three

stages to the illness:

FIGURE 5.23. Steeple sign of croup.

(Reproduced, with permission, from Shah BR, Lucchesi M. Atlas of Pediatric Emergency

Medicine. New York: McGraw-Hill, 2006:241.)