Croup
Signs and Symptoms:
Croup is characterized by a loud cough that resembles the barking of a seal,
difficulty breathing, and a grunting noise or wheezing on breathing. At first a
child may have an upper respiratory infection for several days before the onset
of cough. As the upper airway (vocal cords and the areas just below them)
become progressively inflamed and swollen, the child may become hoarse, with a harsh,
barking cough. If the upper airway becomes more obstructed, the labor of
breathing becomes intense. With severe croup there may be a high-pitched noise
("stridor") when breathing in.
Children with
viral croup may have a fever. Symptoms often worsen at night and with crying.
In addition to the effects on the upper airway, the infections that cause croup
can result in inflammation further down the airway, including the bronchi
(breathing tubes) and the lungs. Possible airway obstruction is a major concern.
Description:
The term "croup" does not refer to a single illness, but rather a
group of conditions involving inflammation of the upper airway, that lead to
the characteristic "croupy" sound, particularly when the child is
crying. Most croup is caused by viruses and occasionally by bacteria. The
viruses most commonly involved are parainfluenza virus (accounting for about
75% of cases), adenovirus, RSV and measels.
Most children
with viral croup are between the ages of three months and five years. Symptoms
are most severe in children under three years of age. The incidence of croup is
more common among males and during the cold season of the year. Most croup due
to viruses is mild and "self-limiting," though rarely viral croup can
be severe and even life-threatening.
The term
"spasmodic croup" refers to a condition similar to viral croup,
except that there are no symptoms of an infection. This frequently begins at
night with a sudden onset. The child usually has no fever with spasmodic croup.
Prevention:
At this time, there are no specific ways to prevent viral croup.
Duration:
Croup resulting from viral infection usually lasts five to six days, though
this varies. Complications of croup, such as ear infection and pneumonia, can
occur as the respiratory symptoms are fading.
Contagiousness:
Croup tends to occur in outbreaks in late fall and winter when the viruses that
usually cause it peak. Most children who come in contact with the viruses that
cause croup will not get croup.
Home
Treatment:
Most (though not all) cases of viral croup are mild. Inhalation of warm, moist
air seems to relieve some of the symptoms. One way to humidify the air is to
use a cool-mist humidifier filled with warm water. Don't use a hot vaporizer;
this can be hazardous. Having the child breathe in the humid mist through an
open mouth may work.
Another thing to
try is to mist up the bathroom with hot shower steam, and have the child sit in
the bathroom for 10 minutes. You can cuddle your child and read a bedtime story
to help calm her or him.
Though no one
knows exactly why it works, sometimes taking the child into the outside air for
a few minutes seems to break the episode of spasmodic croup.
After you break
the croupy attack, you should consider sleeping in the same room as your child
to be able to provide close observation. There should not be any smoking in the
household, since this can make croup worse.
Professional
Treatment:
Most mild croup doesn't require professional intervention. Medical
professionals will need to evaluate a child if there is any suspicion of airway
blockage or bacterial infection.
When to Call:
Immediately call your physician if your child has ANY of the following:
|
Northeast Indiana Pediatric Specialists, PC |
|
Dr. Michael Dick & Dr. Todd Dillon nips@med-web.com |