LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 110 ❚ a. Natural history 1. Know that the course of viral croup in infants younger than 1 year of age is prolonged and often improves during the day with recurrence of symptoms in the early hours of the morning b. Prognosis with therapy b. Epiglottitis 1. Epidemiology a. Know that epiglottis has become rare in children due to Haemophilus influenza vaccine b. Know that epiglottis is more common in the elderly and immune- compromised children than in the general population 2. Etiology a. Know that uncommon pathogens can cause epiglottis, such as herpes group viruses and fungal infections 3. Pathophysiology a. Pathology b. Path mechanisms and consequences 1. Recognize that the pathology of epiglottitis involves the epiglottitis and other supraglottic structures but the subglottic space and trachea are usually spared 4. Diagnosis and clinical manifestations a. History 1. Know that the onset of illness of epiglottitis can be very rapid (hours), consisting of sore throat and difficulty breathing b. Physical examination 1. Know that stridor is not a prominent feature of epiglottitis c. Imaging 1. Recognize the radiographic appearance of acute epiglottitis (positive thumb sign on lateral-view x-ray study of the neck) 2. Recognize the radiographic appearance of a retro-pharyngeal abscess d. Pulmonary function tests e. Other investigations 1. Know the association between Haemophilus influenzae and epiglottitis f. Diagnostic criteria g. Complications 5. Prevention and therapeutic approach a. Prevention 1. Know that haemophilus influenzae vaccination has reduced the prevalence of epiglottitis through both individual and herd immunity b. Therapeutic approach 1. Know that patients with acute epiglottitis should undergo endotracheal intubation to ensure an adequate airway until inflammation subsides 2. Know that a skilled provider needs to remain with a patient with epiglottitis until the airway is visualized and secured c. Side effects of therapy 6. Prognosis