[Solved]: A previously healthy and immunized 18-month-child…

A previously healthy and immunized 18-month-child presented to the emergency department with a 1-day history of noisy breathing. According to the mother, the child was febrile at home for the past 2 days with reduced oral intake. There was no history of cough, choking or foreign body inhalation or recent contact with sick persons with upper respiratory illness. On arrival, the child was tachypneic at 72 breaths per minute with deep subcostal and intercostal retractions and audible biphasic stridor. He also presented with a loud, barky cough. His oxygen saturation was 76% on room air, the heart rate was 210 beats per minute and the recorded temperature was 39.7deg C. Lung auscultation revealed reduced air entry bilaterally. Nebulised and IV corticosteroids showed no improvement.