Cases reported "Croup"

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1/36. Pediatric myocardial infarction after racemic epinephrine administration.

    myocardial infarction is a previously unreported complication of treatment with racemic epinephrine that is used commonly in the emergency department for severe respiratory distress in bronchiolitis or croup syndrome. We describe a pediatric patient who presented with the croup syndrome and severe respiratory distress that required multiple doses of nebulized racemic epinephrine in the emergency department. The patient developed ventricular tachycardia and mild chest discomfort during one treatment, which resolved spontaneously on discontinuation of the nebulization. Persistently abnormal electrocardiograms and elevated creatine phosphokinase MB isoenzyme (CPK-MB) levels suggested a myocardial infarction had occurred. Subsequent echocardiography, cardiac catheterization, and angiography revealed an anatomically normal heart with normal coronary circulation; however, a stress nuclear study showed a small myocardial infarct. The significance of this previously unreported complication of racemic epinephrine is discussed, along with recommendations for proper use in the emergency department. ( info)

2/36. Membranous laryngotracheobronchitis (membranous croup).

    Membranous laryngotracheobronchitis (membranous croup), not previously described as a distinct entity, is characterized by diffuse inflammation of the larynx, trachea, and bronchi with adherent or semiadherent mucopurulent membranes in the subglottic trachea (conus elasticus) and in the upper trachea distal to the conus elasticus. We reviewed 28 cases of membranous croup diagnosed by endoscopy and/or radiographic examination. The importance of the recognition of membranous croup as a distinct entity is discussed. The characteristic radiologic findings consist of subglottic tracheal narrowing, irregularity of contour of the proximal tracheal mucosa, and sometimes detached or partially detached proximal tracheal membranes, which can be mistaken for tracheal foreign bodies. ( info)

3/36. adult croup: a rare but more severe condition.

    We report the first adult patient with virologically confirmed croup caused by parainfluenza virus type 3 and review 10 cases of adult croup described in the English-language literature. Circumstantial evidence of viral infection was present in only 1 other case, in which there was a rise in antibody titer against influenza b virus. Ten patients (91%) required intensive care support. None of the 11 patients died. A comparison was also made between the 11 adults with croup and 43 children hospitalized with severe croup described in a representative paper published in 1984. adult croup represents an apparently more severe disease entity than pediatric croup. ( info)

4/36. delayed diagnosis of laryngeal foreign body.

    Aspiration of a foreign body is a recognized cause of accidental death in children. Paediatricians are aware of the symptoms of inhaled foreign bodies in the lower respiratory tract. However, symptoms which suggest impaction in the larynx do not appear to raise the same index of suspicion of a foreign body. One case of laryngeal foreign body is described with a delay in diagnosis of five days. The clinical presentation, investigations and management are discussed. ( info)

5/36. adult croup--a case report.

    A case of a female adult patient with croup is described. inflammation, as well as pseudomembranes, restricting the patency of trachea, developed within several hours after the first symptoms of infection were observed. tracheostomy was performed Bronchofiberoscopies were repeated on a regular basis several times a day over a period of two weeks, with the removal of fibrinous casts and dense secretion being the only way to save the patient's life. ( info)

6/36. Out-of-hospital cardiopulmonary arrest in children with croup.

    Viral laryngotracheobronchitis is a ubiquitous infectious process that has not caused significant mortality in the past 20 years. Bacterial tracheitis and pneumonia can complicate viral laryngotracheobronchitis and markedly increase the risk of bad outcome. Even uncomplicated, properly managed, viral laryngotracheobronchitis can occasionally result in death, particularly in the infant age group. ( info)

7/36. candida laryngotracheitis: a complication of combined steroid and antibiotic usage in croup.

    The use of corticosteroids to reduce the morbidity associated with laryngotracheobronchitis (croup) has been a controversial issue for many years. Recent literature, however, does support a decreased morbidity and increased clinical response when short-term steroids are used. As a prophylactic measure against bacterial superinfection, antibiotics are commonly utilized in the treatment of croup. We present the case of an otherwise healthy infant with severe croup who was hospitalized and treated with both steroids and antibiotics. A relapse in her symptoms led to the diagnosis of candida laryngotracheitis. We recommend close monitoring of patients with croup treated aggressively with steroids and antibiotics. Steroid use should be limited to 24 h with antibiotics reserved for patients with signs of bacterial infection. ( info)

8/36. Artificial nail aspiration masquerading as refractory croup.

    Infants with an aspirated foreign body who present with acute onset of obstructed airflow should be readily diagnosed. When aspirated foreign body is overlooked, patients may present with recurrent inspiratory, biphasic, or expiratory stridor. We report an infant who repeatedly presented with varying degrees of inspiratory stridor. The diagnosis of aspirated foreign body was hampered by the presence of respiratory syncytial virus infection with the initial episode. ( info)

9/36. A case report of adult croup: a new old problem.

    Larnygeotracheobronchitis is a common disease of childhood most often associated with infection by parainfluenza virus. Although rare, adult cases have been reported. adult croup presents similarly to the childhood version; however, the severity is usually much worse, often leading to hospitalization. Presented is the case of an 80-year-old woman with croup, which is the twelfth reported in the English literature. ( info)

10/36. Multiple pulmonary abscesses caused by legionella pneumophila infection in an infant with croup.

    Legionella infections are uncommon in childhood. We report the case of an infant who developed multiple pulmonary abscesses caused by legionella pneumophila after receiving prolonged corticosteroid treatment of severe croup. Diagnosis was not suspected because immunosuppression was not initially considered. Caution should be used when prolonging high-dose corticosteroids in children with respiratory diseases. ( info)
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