Inflammatory disorders of the pediatric upper airway

Viral croup and epiglottitis are the most important inflammatory causes of upper-airway obstruction in children. Each presents with a characteristic clinical pattern. Recent developments in the evaluation and management of viral croup include improved clinical scoring systems and guidelines for using racemic epinephrine and systemic steroids during outpatient management. There has also been progress in antiviral vaccines to control croup and other parainfluenza viral diseases. Since the introduction of Haemophilus influenzae type B vaccine, favorable epidemiologic patterns of epiglottitis have emerged. This article discusses these recent developments and attempts to relate them to the traditional diagnostic and therapeutic approaches to croup and epiglottitis.