Croup (inflammation of upper tract)

Neck | General Practice | Croup (inflammation of upper tract) (Disease)


Croup is an infection at the site of the throat (larynx) and windpipe (trachea) that gives a noisy breathing and a harsh, barking cough. Most children who have croup are under five years old.

Viral croup may have two distinct presentations both of which are a consequence of swelling of the vocal cords and therefore narrowing of the airway. The more common variety causes symptoms of fever (100 F-103 F), mild hoarseness, and sore throat two to three days after virus exposure. The characteristic dry barking seal cough is soon to follow. The barking cough may be associated with a harsh, raspy sound during inspiration.

Children with croup usually have an illness like a cold first – a runny nose, cough and slight temperature. Then the child wakes during the night with a barking cough and difficulty breathing. This can last a couple of hours and reappear for the next couple of nights.

Children are small, so their airway is narrow. When infection causes swelling of the lining of the airway, it becomes even narrower making it difficult for the child to breathe. This happens particularly when the air is cold, such as at night-time.

Causes and risk factors

Croup is contagious and is usually spread by airborne infectious droplets sneezed or coughed by infected children. When a healthy child inhales infectious droplets, symptoms can develop in two to three days.

The infection can also be spread by infected mucus deposited on doors, furniture, toys, and other objects. A healthy child can become infected by accidentally touching the infectious mucus and transferring the infection into his/her mouth.

Diagnosis and Treatment

Some older children (aged between three and eight years) may develop occasional croup. It may produce mild, moderate, or severe symptoms, which often worsen at night. It is often treated with a single dose of oral steroids; occasionally epinephrine is used in more severe cases. Hospitalization is rarely required. ...

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