Croup

Croup is swelling in the voice box and wind pipe. The swelling can make it difficult to breathe. This can cause a barking cough. Croup occurs most often in children between age six months and three years. This is because young children have a smaller airway. Airways become wider as children grow. This decreases the chance of croup in older children and adults.

  • Causes

    Croup is caused by viral infections such as:

    • Parainfluenza
    • Paramyxovirus
    • Influenza
      virus type A
    • Respiratory syncytial virus
    • Adenovirus
    • Rhinovirus
    • Enterovirus
    • Coxsackievirus
    • Enteric cytopathogenic human orphan virus
    • Reovirus
    • Measles
      virus

  • Definition

    Croup
    is swelling in the voice box and wind pipe. The swelling can make it difficult to breathe. This can cause a barking cough. Croup occurs most often in children between age six months and three years. This is because young children have a smaller airway. Airways become wider as children grow. This decreases the chance of croup in older children and adults.

    Upper Respiratory System in a Child
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  • Diagnosis

    Your doctor will ask about your child's symptoms and medical history. A physical exam will be done.

    Tests are not always needed. If croup is severe or not clear, your doctor may request:

    • Blood tests—to check for signs of infection

    • Neck
      x-rays
      —to look for changes associated with croup
    • Laryngoscopy
      —a thin tube inserted into your mouth to look at throat tissue. A sample of mucus from your wind pipe may be taken. It will be tested for infection.

  • Prevention


    Croup usually occurs due to an upper respiratory infection. Take steps to decrease your child's chance of catching
    colds
    and
    flu. Wash your hands often. Avoid contact with people that have cold or flu when possible.


    Yearly
    influenza immunization
    can prevent cases of croup due to influenza A. Influenza immunization is strongly recommended for all children between the ages of six months and five years.

  • Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition. Risk factors for croup include:

    • Age: three years or younger
    • Attending day care
    • History of croup
    • Family history of croup

    • Frequent
      upper respiratory infections
    • Colder months: October through March

  • Symptoms

    Croup often begins with symptoms similar to an upper respiratory infection. The symptoms can come on suddenly and often at night. The following is a list of common croup symptoms:

    • Cough spasms
    • Cough that sounds like a barking seal
    • Hoarseness
    • Fever
    • A harsh, high-pitched sound when your child breathes in, especially when crying or upset
    • Trouble breathing, especially breathing in
    • Poor appetite and fluid intake

    More serious symptoms of croup that may require immediate medical attention include:


    • Bluish color of nails, lips, or around the mouth—This is an absolute emergency.
      Call 911
      .

    • Decreased alertness—This is also a very serious symptom.
      Call 911
      .
    • Restlessness or agitation—This can be due to dangerous lack of oxygen.
    • Struggling for each breath
    • Harsh, high-pitched breath sounds even at rest
    • Trouble swallowing
    • Drooling
    • Inability to speak due to trouble breathing
    • Nausea and vomiting
    • Dizziness or lightheadedness
    • Rapid, irregular heartbeat; chest pain

    • Rash or
      hives
    • High fever

  • Treatment

    The goal is to keep your airway open until the infection clears. The infection causing croup will resolve on its own in 5-7 days. Severe symptoms usually resolve in 3-4 days.


    If your child is diagnosed with croup, follow your doctor's
    instructions
    .
    Treatment options include: