1. Background

• major pathophysiologic process is acute spasm of the larynx
• also referred to as spasmodic croup

2. Etiology

1. Prodrome

• usually preceded by mild-to-moderate coryza and hoarseness

2. Respiratory Manifestations

• croupy cough and inspiratory stridor:
  • sudden onset usually at night during sleep
  • episodes tend to be brief (hours) and occur over 2-3 nights
  • tends to recur throughout year
  • symptoms less severe than in infectious croup
  • patients appear well after an episode except for slight hoarseness and cough

3. Complications

• upper airway obstruction:
  • may range from mild inspiratory and expiratory stridor to severe respiratory distress

1. Direct Laryngoscopy

• usually normal

2. Throat Culture

• swab for C & S

1. Supportive

• respiratory support with severe or life-threatening upper air-way obstruction, i.e., intubation, tracheostomy

2. Breaking of Laryngeal Spasm

• episode may be broken by humidified air (cold or warm) used either acutely or over 2-3 days until the cough has subsided
• may also break episode by inducing vomiting, i.e., 1 tbsp. of ipecac