Croup

Croup is inflammation or infection of the voice box and windpipe. The inflammation causes tissue in the respiratory tract to swell, so less air is able to reach the lungs.Croup occurs in young children. As children grow older, the air passages widen so swelling enough to block breathing is less likely.

Causes

Causes of Croup include:
  • Viral infections, including:
    • Parainfluenza
    • Paramyxovirus
    • Influenza virus type A
    • Respiratory syncytial virus
    • Adenovirus
    • Rhinovirus
    • Enterovirus
    • Coxsackievirus
    • Enteric cytopathogenic human orphan virus
    • Reovirus
    • Measles virus
  • Bacterial infections
  • Allergies

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Age: 3 years old or younger
  • History of croup
  • Family history of croup
  • Frequent upper respiratory infections
  • Colder months: October through March

Symptoms

Symptoms are usually preceded by an upper respiratory infection. Croup symptoms come on suddenly, often at night.

Symptoms may include:
  • Cough spasms
  • Cough that sounds like a barking seal
  • Hoarseness
  • Fever
  • Fatigue
  • Harsh, high-pitched breath sounds, especially when crying or upset
  • Trouble breathing
  • Poor appetite and fluid intake
More serious symptoms of Croup that may require immediate medical attention include:
  • Bluish color of the nails and lips, or around the mouth
  • Struggling for each breath
  • Harsh, high-pitched breath sounds even at rest
  • Whistling noise during breathing that gets progressively worse
  • Trouble swallowing
  • Drooling
  • Inability to speak due to trouble breathing
  • Decreased alertness
  • Restlessness or agitation

Diagnosis

The doctor will ask about your childs symptoms and medical history, and perform a physical exam.

Tests may include:

Blood Tests – to check for signs of infection

Neck X-rays – to look for changes associated with croup

Laryngoscopy – a thin tube inserted into the mouth to look at throat tissue (A culture of mucous from the windpipe may be taken during this procedure and tested for infection.)

Treatment

Treatment aims to keep the airway open.

Therapies include:

Self-Care and Humidification
  • Try to keep your child calm and quiet. Crying can make the symptoms worse.
  • Moist air will help to keep the passageway open. Take the child into the bathroom and close the door. Let the hot water run in the shower and fill the room with moisture. Sit with the child in the moist air for 15-20 minutes. Never leave a child unattended with hot water running or a tub of water nearby.
  • Repeat the bathroom steam treatments as needed. Or try running a warm- or cold-water humidifier in your child's room.
  • If the moist-air treatments do not help breathing or your child's condition is getting worse, seek medical care.
  • Call the doctor or emergency medical services (9-1-1). Do not hesitate to call even if the attack occurs during the night.
Medication

The doctor may prescribe steroids to reduce swelling in the airways. Since croup is caused by a viral infection most of the time, antibiotics are not ordered unless the doctor suspects a bacterial infection.

Hospital Care
  • A child with serious croup may be placed in a croup tent. Cool, moist air is delivered inside this plastic tent.
  • Medications may be given to treat inflammation and respiratory distress.
  • If the child continues to get worse, a breathing tube may be inserted in the throat to help keep the airway open.
  • Fluids can be given through a vein if necessary.
  • The child's oxygen level and heart rhythm are monitored.
  • In severe cases, a surgical procedure called a tracheostomy can be performed to keep the airway open.

Prevention

Croup usually occurs in response to an upper respiratory infection. Minimizing exposure to viruses that cause colds and flu may help prevent croup.