Croup

Croup  

What is Croup?

Viral croup, or laryngotracheobronchitis, is an infection of the vocal chords (larynx) that causes a cough that sounds like a seal’s bark (insert audio of child with croup) and noisy breathing. Croup is usually caused by a group of organisms called the parainfluenzae viruses. Other viruses, such as measles and adenovirus may also cause croup. Although anyone at any age can develop croup, it mostly occurs in babies and children between 3 months and 5 years of age. In the northern part of the country, the infection is most common in the late fall through early spring. However, infection can occur at any time of year. In the past, diphtheria caused a deadly form of croup. Routine childhood immunizations have made diphtheria rare today. Still, bacteria can sometimes cause croup-like illness or make viral croup worse. Signs of bacterial infection include worsening of croup symptoms, high-grade fever (>102 degress F, rectally; see section Taking Baby’s Temperature), and increased difficulty breathing. Another serious form of croup is called epiglottitis. Epiglottitis causes a sudden blockage of the airways; epiglottitis is a life-threatening conditions and requires emergency treatment!! It is important to seek immediate medical attention when symptoms of croup are severe or get worse (see “When to go to the emergency room or call 911” below). (Insert picture of “tripod” and drooling for epiglottitis).

Today, most croup infections are not life-threatening. Still, it can be frightening when your child seems to be struggling to breathe. Because anxiety and crying can make the symptoms worse, it is important to remain calm and keep your child as calm as possible. Try to remember that croup is rarely as serious as it appears to be. If symptoms occur in the middle of the night, which they often do, there are some simple things you can do to relieve symptoms. For tips on how to relieve croups symptoms, see the treatment section. If symptoms do not respond, or if symptoms are worsening, call your physician immediately!! In mild cases, you can usually wait until morning to call your child’s doctor. He or she may want to examine your child just to make sure things are okay.

Key points:
1. Croup is usually a self-limited infection that affects the vocal chords (larynx), and causes them to swell. The most notable symptoms are a “seal” cough and noisy, difficult breathing (insert audio of child with croup).
2. Croup most often occurs in babies and children and is caused by a respiratory virus. Symptoms usually come on during the night and recur over the next few nights.
3. Remember that croup is often not as serious as it seems. Still, you should call your child’s doctor the following morning.

NOTE: Though uncommon, croup can sometimes become very serious. See the “When to go to the emergency room or call 911” for signs and symptoms that your child should receive emergency treatment.

What are the Symptoms?

The most recognizable symptom of croup is the cough, which sounds like a barking seal (insert audio link). Hoarseness, along with difficult, noisy breathing are also common. Symptoms are caused by swelling and mucus production in the vocal chords. Before the onset of croup, your child may experience symptoms of a typical cold, such as runny nose, low-grade fever (see separate section Taking Baby’s Temperature), and a mild cough. The barking cough and difficulty breathing often begin within a day or two after the start of cold symptoms, usually during the night. You many be awakened in the middle of the night by the sounds of the barking cough (insert audio of child with croup). Your child may appear to be gasping for air and choking, which can be frightening. Because anxiety and crying can make symptoms worse, it is important to remain calm and keep your child calm. Remember that croup is often not as serious as it looks and there are some simple things you can do to relieve symptoms. See the treatment section for tips on relieving symptoms Symptoms may get better during the day but recur during the next few nights. Most often, symptoms of croup go away entirely within 3 to 7 days.

Key points:
1. Symptoms of viral croup include a distinctive “seal-like” barking cough and noisy, difficult breathing (insert audio of child with croup).
2. Children may show symptoms of a common cold (runny nose, mild cough) a few days before the onset of croup symptoms, which usually occur during the night.
3. Symptoms of viral croup may get better during the day and recur at night. In most cases, symptoms go away after 3 to 7 days.

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