---
title: "Croup vs Acute epiglottitis - Differences"
description: "Key differences between Croup and Acute epiglottitis."
source: "The ENT Resident"
author: "Dr. Mausumi Das"
canonical_url: "https://www.theentresident.com/ent-notes-lectures/croup-vs-acute-epiglottitis-differences"
categories: ["Larynx and Trachea", "Differences Tables in ENT"]
video: "https://www.youtube.com/watch?v=ql5SQAe7zPc"
image: "https://media.theentresident.com/og-images/croup-vs-acute-epiglottitis-differences.png"
---

# Croup vs Acute epiglottitis - Differences

Key differences between Croup and Acute epiglottitis. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=ql5SQAe7zPc

Croup and Acute Epiglottitis are both **acute laryngeal infections** seen in children, but they differ significantly in their **causative pathogen, age group, site of obstruction, clinical features, radiological signs and management**.

| Feature | Croup | Acute Epiglottitis |
| --- | --- | --- |
| **Definition** | Acute inflammatory condition involving the larynx, trachea and bronchi | Acute infection involving the supraglottic region |
| **Other Names** | Acute or Viral Laryngotracheobronchitis | Supraglottitis, Acute Supraglottic Laryngitis |
| **Most Common Pathogen** | Parainfluenza virus type 1 | Haemophilus influenzae type B |
| **Type of Organism** | Viral | Bacterial |
| **Age Group** | 6 months to 3 years | 2 to 8 years |
| **Site of Obstruction** | Subglottis | Supraglottis, including the epiglottis |
| **Prodromal Cold Symptoms** | Present | Absent |
| **Onset** | Gradual, over days | Abrupt, within hours |
| **Progression** | Slow | Rapid |
| **Temperature** | Low grade fever or no fever | High grade fever |
| **Appearance of the Child** | Not toxic | Toxic look |
| **Cough** | Brassy, barking cough | Not a feature |
| **Voice** | Hoarse voice | Muffled voice |
| **Dysphagia** | Usually absent | More commonly present |
| **Drooling of Saliva** | Absent | Present |
| **Airway Obstruction** | Mild to moderate, develops gradually | Severe, rapidly progressive and life threatening |
| **Position of the Child** | Lies down comfortably, with no characteristic posture | Tripod posture (Tripod sign) |
| **X-ray Finding** | Steeple sign on X-ray neck, AP view | Thumb sign on X-ray neck, lateral view |
| **Laryngoscopy** | Usually unnecessary, but not contraindicated | Should not be attempted; if required, only in the OT with intubation facilities available, as it may precipitate airway obstruction |
| **Response to Steroids and Nebulized Epinephrine** | Dramatic improvement | Minimal role |
| **Need for Airway Intervention** | Rarely requires intubation | Often requires intubation or tracheostomy |

> What are the [differences between the adult and pediatric larynx](https://www.theentresident.com/ent-notes-lectures/adult-vs-pediatric-larynx.md)?

> What is Tripod sign seen in Acute Epiglottitis?

> What is Thumb sign?

> What is Steeple sign?

> What is the typical cough seen in Croup called as?

> What is the typical voice seen in Acute epiglottitis called as? Why?

> What are the indications of intubation in Croup and Acute epiglottitis?

> Which is the symptom used to differentiate between a case of Croup and Acute epiglottitis?

> What is the [Westley Croup Score](https://www.theentresident.com/ent-notes-lectures/croup-causes-symptoms-treatment-steeple-sign.md)?

> What are the [signs seen in Croup and Acute Epiglottitis](https://www.theentresident.com/ent-notes-lectures/steeple-croup-thumb-tripod-sign-epiglottitis.md)?

---

### Viva Pearls

* **Croup = Larynx, trachea and bronchi**
* **Acute epiglottitis = Supraglottis**
* Most common pathogen in croup is **Parainfluenza virus type 1**
* Most common pathogen in acute epiglottitis is **Haemophilus influenzae type B**
* Site of obstruction:

  * Subglottis → Croup
  * Supraglottis → Acute epiglottitis

* **Tripod sign** is the characteristic posture in acute epiglottitis
* Radiological signs:

  * Steeple sign (AP view) → Croup
  * Thumb sign (lateral view) → Acute epiglottitis

* Laryngoscopy in acute epiglottitis may precipitate airway obstruction
* Croup responds dramatically to steroids and nebulized epinephrine

---

## About This Note

This free ENT note on Croup vs Acute epiglottitis - Differences was written by Dr. Mausumi Das and is paired with a corresponding video lecture.

Canonical page of this note: https://www.theentresident.com/ent-notes-lectures/croup-vs-acute-epiglottitis-differences

When citing or referencing this content, please credit The ENT Resident and link to the canonical page above.

## Related Notes by Category

- Larynx and Trachea: https://www.theentresident.com/ent-notes-lectures/category/larynx-and-trachea.md
- Differences Tables in ENT: https://www.theentresident.com/ent-notes-lectures/category/differences-tables-in-ent.md

## About The ENT Resident

The ENT Resident is an educational website and resource library created by Dr. Mausumi Das (MS ENT) for ENT residents, ENT postgraduates preparing for exams, and MBBS students.

Dr. Mausumi Das writes the notes, draws the diagrams, and records the lectures herself.

Browse all ENT notes and lectures on The ENT Resident: https://www.theentresident.com/ent-notes-lectures.md

## Medical-use Boundary

The ENT Resident provides educational material for medical learning and revision. It does not provide patient-specific medical advice, diagnosis, or emergency care, and it is not a substitute for evaluation by a qualified healthcare professional.

## More Resources

- Learn about the Premium ENT Notes, preview a complete sample, and find purchase options: https://www.theentresident.com/premium.md
- Premium note for this topic, Croup vs Acute epiglottitis - Differences: https://theentresident.gumroad.com/l/ucjkek
- Read student testimonials: https://www.theentresident.com/testimonials.md
- Contact The ENT Resident: https://www.theentresident.com/contact.md

---

A complete index of all pages on this site, with descriptions and markdown links can be found here: https://www.theentresident.com/llms.txt