The most common cause of acute stridor in childhood is
laryngotracheobronchitis or croup. Parainfluenza virus is the
most common causative agent, with influenza virus types A
or B, respiratory syncytial virus, and rhinoviruses also being
Children between the ages of 6 months and 3
years are affected, with a peak incidence in the second year
of life. A history of preceding upper respiratory tract
infection is usually present. Symptoms include low-grade
fever, barking cough, inspiratory stridor, and hoarseness.
These are characteristically worse at night and are
aggravated by agitation and crying. If the diagnosis is clear,
no endoscopy is needed. Humidification, oxygen, nebulized
steroids, and nebulized adrenaline with systemic steroids are
recommended in croup. Severe cases may need
intubation and ventilation for a few days. Recurrent croup
should raise the suspicion of congenital subglottic stenosis.


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