Croup

Written by Marissa Selner and Jennifer Nelson | Published on August 16, 2012
Medically Reviewed by George Krucik, MD

What Is Croup?

Croup is a viral condition that causes swelling around the vocal cords. It is characterized by breathing difficulties and a bad cough that sounds like a barking seal. Many of the viruses responsible for croup also cause the common cold. Most active in the fall and winter months, croup usually targets children under the age of 5.

What Causes Croup?

There are several viruses that can cause croup. Seventy-five percent of cases come from parainfluenza viruses (the common cold). Other viruses that may cause croup include adenovirus (another group of common cold viruses), respiratory syncytial virus (RSV), the most common germ affecting young children, and measles. Croup may also be caused by allergies, exposure to inhaled irritants, or bacterial infections. But these are rare.

What are the Symptoms of Croup?

Symptoms tend to be most severe in children under the age of 3. This is because a child’s respiratory system is smaller than an adult’s. The following symptoms are common in most cases of croup:

  • cold symptoms such as sneezing and runny nose
  • fever
  • barking cough
  • heavy breathing
  • hoarse voice

Immediate medical attention is required if croup threatens your child’s ability to breath. Contact your doctor as soon as possible if you notice any of the following symptoms:

  • high pitched sounds when breathing
  • difficulty swallowing
  • blue or gray skin coloring around the nose, mouth, and fingernails

Croup that persists longer than one week, reoccurs frequently, or is accompanied by a fever higher than 103.5 degrees, should be brought to a doctor’s attention. An examination is needed to rule out bacterial infections or other more serious conditions.

Spasmodic Croup

Some children suffer from a recurring, mild case of croup that appears along with the common cold. This type of croup features a barking cough, but doesn’t include a fever often seen with other cases of croup.

Diagnosing Croup

Croup is generally diagnosed during a physical exam. Your doctor will likely listen to the cough, observe breathing, and ask for a description of symptoms. Even when an office visit is not necessary, doctors and nurses may diagnose croup by attentively listening to the characteristic cough over the phone. If croup symptoms are persistent, your physician may order a throat exam or X-ray to rule out other respiratory conditions.

Treating Croup

Mild Cases

Most cases of croup are effectively treated at home. Doctors and nurses can easily monitor a child’s progress by talking to parents over the phone. Cool mist humidifiers may help your child breathe easier as he or she sleeps. Over-the-counter pain relievers can soothe discomfort in the throat, chest, or head. Cough medicines should only be administered upon advice from a medical professional.

Severe Cases

If your child is having problems breathing, an emergency visit to a hospital or clinic is warranted. Physicians may choose to use steroid medications to open your child’s airways, allowing easier breathing. These may be prescribed for extended use at home. In extreme cases, a breathing tube may be used to help your child get enough oxygen. If it is determined that a bacterial infection is responsible for croup, antibiotics will be administered in the hospital and prescribed for later use. Dehydrated patients may require intravenous fluids.

Prognosis: What to Expect in the Long Term?

Croup that is caused by a virus usually goes away on its own within one week. Bacterial croup may require antibiotic treatment. The duration of the antibiotic therapy will depend on the severity of the infection. Life-threatening complications are not common, but are dangerous when they do occur. Since the complications usually involve difficulty breathing, it is important that caretakers who observe alarming symptoms have the patient immediately treated.

Prevention

Most cases of croup are caused by the same viruses that cause the common cold or influenza. Prevention strategies are similar for all these viruses. They include frequent hand washing, keeping hands and objects out of the mouth, and avoiding people who are not feeling well.

Some of the most serious cases of croup are caused by conditions such as measles and diphtheria, a serious bacterial infection children are vaccinated against. To avoid these dangerous ailments, parents should keep their children on schedule for appropriate vaccinations.

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