Croup

DEFINITION

Croup refers to an infection of the upper airway, generally in children, which obstructs breathing and causes a characteristic barking cough.

The cough and other symptoms of croup are the result of inflammation around the vocal cords (larynx), windpipe (trachea) and bronchial tubes (bronchi). When a cough forces air through this narrowed passage, the swollen vocal cords produce a noise similar to a seal barking. Likewise, taking a breath often produces a high-pitched whistling sound (stridor).

Croup usually isn’t serious and most cases can be treated at home.

CAUSES

Croup is usually caused by a virus infection, most often a parainfluenza virus.

Your child may contract a virus by breathing infected respiratory droplets coughed or sneezed into the air. Virus particles in these droplets may also survive on toys and other surfaces. If your child touches a contaminated surface and then touches his or her eyes, nose or mouth, an infection may follow.

The infection usually starts in the nasal membranes and then spreads to the vocal cords (larynx) and windpipe (trachea). Only a small percentage of exposed children actually develop croup.

SYMPTOMS

Croup often begins as a typical cold.  If there is enough inflammation and coughing, a child will develop a loud barking cough. This often is worse at night, and is further aggravated by crying and coughing, as well as anxiety and agitation, setting up a cycle of worsening symptoms. Fever and a hoarse voice are common, too. Your child’s breathing may be noisy or labored.

Because children have small airways, they are most susceptible to having more marked symptoms with croup, particularly children younger than three years old.

Nighttime croup symptoms of labored breathing can often lead concerned parents to bring their child to the emergency room.

Symptoms of croup usually last for three to five days.

When to see a doctor

Less than 5 percent of children develop airway obstruction serious enough to require hospitalization. You should seek immediate medical attention if your child:

• Makes noisy, high-pitched breathing sounds (stridor) both when inhaling and exhaling
• Begins drooling or has difficulty swallowing
• Seems anxious, agitated or fatigued
• Breathes at a faster rate than usual
• Struggles to breathe
• Develops blue or grayish skin around the nose, mouth or fingernails (cyanosis)