Croup revealing a bacterial tracheitis in a five-year-old child

Case report. - We report the case of a five-year-old boy with clinical feat ures of croup and left lower lobe pneumonia. Response to inhaled adrenaline and dexamethasone was incomplete and he developed respiratory distress. Di rect laryngoscopy performed in the operating room showed mild glottic and s ubglottic inflammation. On bronchoscopy, there was thick pus coming from th e left lower lobe. He was intubated for three days and regular toilet broug ht back thick pus. Tracheal fluid culture grew Haemophilius influenzae. Comments. - We suggest that he had bacterial tracheitis but that the trache al involvement was not prominent at the time of diagnosis. Conclusion. - Laryngoscopy and bronchoscopy in specialized surroundings sho uld be considered for each child with croup unresponsive to conventional tr eatment, especially in case of lower respiratory tract involvement. (C) 200 1 Editions scientifiques et medicales Elsevier SAS.