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Croup

(Laryngotracheobronchitis)

Definition

Croup is swelling in the voice box and wind pipe. The swelling can make it hard to breathe. It can also cause a barking cough.
Upper Respiratory System in a Child
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Causes

Croup is caused by viral infections such as:

Risk Factors

Croup is most common in children between 6 months and 3 years of age. This is because young children have a smaller airway. Croup is also more common in the fall and early winter months.
Other things that may raise the risk are:

Symptoms

The first symptoms may be like a common cold. They often happen at night. Croup symptoms may be:
  • Cough spasms
  • A cough that sounds like a barking seal
  • Hoarseness
  • Fever
  • Problems breathing
  • A harsh, high-pitched sound when your child breathes in, especially when crying or upset
  • Drooling and problems swallowing
  • Decreased alertness
  • Bluish color of nails, lips, or around the mouth

Diagnosis

You will be asked about your child's symptoms and health history. A physical exam will be done. This is often enough to make the diagnosis.

Treatment

The infection often goes away in a week. The goal of treatment is supportive care while the child heals. This may include things like fluids and warm, moist air to help with breathing.
Children with severe symptoms may need a breathing tube placed in the throat to help open the airway. This is not common.

Medicine

Medicine may be needed to manage symptoms. The ones given depend on whether croup is mild or severe. They may be:
  • Over-the-counter medicine to lower fever and ease discomfort
  • Steroids to reduce swelling in the airways
  • Epinephrine to ease swelling until steroids start to work
  • Oxygen therapy for severe breathing problems

Prevention

The risk of croup can be lowered by washing hands often and making sure a child's vaccines are up to date.

RESOURCES

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org
Kids Health—Nemours Foundation
http://www.kidshealth.org

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca
Health Canada
https://www.canada.ca

References

Croup. Family Doctor—American Academy of Family Physicians. website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/croup.printerview.all.html. Updated March 20, 2017. Accessed January 9, 2020.
Croup. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/croup . Updated December 12, 2019. Accessed January 9, 2020.
Smith DK, McDermott AJ, et al. Croup: Diagnosis and Management. Am Fam Physician. 2018 May 1;97(9):575-580.
What is croup and how is it treated? Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/chest-lungs/pages/Croup-Treatment.aspx. Updated November 21, 2015. Accessed January 9, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 09/2019
  • Update Date: 01/09/2020
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