My 6 year old son has had recurrent moderate to severe (stridor, insp./expatory retractions unresponsive to home care) viral croup 1 -2 times per year since 9 months of age. He is treated w/ racemic Epi and decadron in the ER and has needed hospital admission 5 times (never intubated). We see pediatrician, allergist/asthma specialist, and have seen peds. ENT. Bronchoscpy and PFTs at baseline are NL. ***** test has shown reactions which do not seem clinically relevant... but ? predictive of a risk for developing asthma.
Prevention? Currently he is on pulmnicort inhaler 2 puffs Q AM and we have prednisolone to dose PRN if early suspicion of croup is present (i.e. hoarseness + suspicious cough). Since he has not shown signs of small airway reactivity is the pulmnicort inhaler of any use? We have an apt. w/ ped. pulmnologist pending. Any other ideas re. prevention plan? Do your patients ever have racemic epi at home to dose before heading to the hospital or calling 911?
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