Croup is a common
respiratory problem in young children. It tends to
occur in the fall and winter. Its main symptom is a harsh, barking cough. Croup
causes swelling and narrowing in the voice box, windpipe, and breathing tubes
that lead to the lungs. This can make it hard for your child to breathe.
An attack of croup can be scary, but it is rarely serious. Children
usually get better in several days with rest and care at home.
Croup usually occurs a few days
after the start of a cold and is usually caused by the same viruses that cause
the common cold. Croup is contagious. The germs that cause it can be passed
from one person to another through coughing and sneezing and through close
contact. Regular hand-washing and limiting contact with others can help prevent
the spread of croup.
As children grow older and their lungs
and windpipes mature, they are less likely to get croup. Getting a flu vaccine
each year may help your child fight off some of the viruses that can lead to
Symptoms of croup are
caused by narrowed airways. They may include:
Symptoms of croup often improve during the day
and get worse at night. Sometimes children have croup attacks that wake them up
in the middle of the night for a couple of nights in a row. Unless the illness is severe, a child with croup is usually alert and active. The child's temperature is usually normal or only slightly higher than normal.
The illness usually improves in 2 to 5 days.
Your doctor will probably
be able to tell whether your child has croup based on your child's symptoms and a physical exam. The doctor may be able to identify the barking cough of
croup over the phone.
The doctor may place a small clip called a
pulse oximeter on your child's finger, toe, or earlobe
to make sure that enough oxygen is reaching the blood.
Even though your child's
coughing and troubled breathing can be frightening, home treatment usually
eases the symptoms.
If your child's symptoms don't get better after 30
minutes, call your child's doctor. Because attacks often occur in the middle of the night
when your doctor is probably not available, you may have to go to the emergency
If your child has
severe difficulty breathing, call 911 or other emergency services immediately.
When home treatment isn't enough, medicines such as glucocorticoids or epinephrine may be used to decrease
airway swelling. These are usually given in a doctor's office or an emergency
room. In rare cases, your child may need to stay in the hospital to get extra oxygen or other treatment.
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Learning about croup:
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Other Works Consulted
Cherry JD (2009). Croup (laryngitis, laryngotracheitis, spasmodic croup, laryngotracheobronchitis, bacterial tracheitis, and laryngotracheobronchopneumonitis). In RD Feigin et al., eds., Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed., vol. 1, pp. 254–268. Philadelphia: Saunders Elsevier.
Federico MJ, et al. (2011). Respiratory tract and mediastinum. In WW Hay et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 487–535. New York: McGraw-Hill.
Hall CB, McBride JT (2010). Acute laryngotracheobronchitis (croup). In GL Mandell et al., eds, Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed., vol. 1, pp. 825–829. Philadelphia: Churchill Livingstone Elsevier.
Johnson D (2009). Croup, search date June 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
May 29, 2012
John Pope, MD - Pediatrics
& Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics
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