Subject(s)
Education, Medical, Undergraduate , Students, Medical , Emotions , Humans , Nepal , NeurosurgeonsSubject(s)
Education, Medical, Undergraduate , Neurosurgery , Students, Medical , Humans , Nepal , Neurosurgery/education , Public OpinionSubject(s)
Education, Medical, Undergraduate , Neurosurgery , Students, Medical , Career Choice , Humans , Nepal , Neurosurgery/educationABSTRACT
An 88-year-old woman presented to our emergency room with complaints of fever, coryza, barking cough and generalised fatigue for 2 days. Physical examination showed stridor, tachypnoea with use of accessory muscles of respiration on admission. Laboratory tests were unremarkable except for monocytosis with a normal total white cell count. Rapid influenza diagnostic test was positive for influenza A. Chest X-ray showed subglottic narrowing of the trachea suggestive of steeple sign. A diagnosis of influenza A-induced croup was made. She was given humidified oxygen, nebulised racemic epinephrine, intravenous dexamethasone and oseltamivir. Stridor resolved within minutes of giving nebulised epinephrine. Work of breathing improved within 4-6 hours. She was discharged 2 days later on a tapering dose of steroids.