Croup (KROOP) is an infection involving the trachea (windpipe) and larynx (voice box) that typically occurs in childhood. It causes inflammation and narrowing of the upper airway, sometimes making it difficult to breathe. The characteristic symptom is a barking cough.
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Respiratory syncytial virus (RSV)
* trochea (TRAY-kee-uh) is the windpipe, the firm, tubular structure that carries air from the throat to the lungs.
What Is Croup?
Croup is an infection of the throat typically occurring in childhood that causes the lining of the trachea * and larynx * to swell, narrowing the upper airway and sometimes making it difficult to breathe. The characteristic symptom is a barking cough. In more severe cases of croup, a high-pitched or squeaking noise called stridor * can be heard when the child takes a breath. The symptoms of the infection can appear suddenly, or develop over a few days. Common cold symptoms, such as a runny nose, usually precede the onset of the barking cough. An allergy or a bacterial infection can produce symptoms of croup, but the most common culprit is a virus, usually parainfluenza * virus. Influenza viruses, adenovirus * , respiratory syncytial virus * , and measles virus also can cause croup.
Who Gets Croup?
Croup is most common during the winter months and in the early spring. The condition tends to develop in children who are between the ages of 3 months and 5 years. In the same way that an adult with a cold might have laryngitis * , a child with a cold might get croup. In fact, many of the viruses that cause croup in children can lead to laryngitis in adults. Some children are more prone to croup, such as those who are born prematurely or who have narrowed upper airways. These children may get symptoms of croup every time they have a respiratory illness. Although the viruses that cause croup can pass easily between children through respiratory secretions, most children who come into contact with those viruses will not get croup.
What Are the Symptoms and Complications
A low fever is common, and children with croup usually have a barking cough. In severe cases, when their airways become more swollen and narrowed, children might experience difficulty breathing. Fast breathing and stridor may develop. If the body is not getting enough oxygen, the lips, tongue, and skin around the mouth can start to appear bluish. Crying can make the breathing symptoms worse. The symptoms also tend to worsen at night, when children are tired, and a child with croup often will have trouble sleeping or even resting. Croup symptoms typically peak 2 to 3 days after they start, and the illness generally lasts less than a week. In a small number of cases, children may have such complications as an ear infection or pneumonia.
How Is Croup Diagnosed?
A barking cough and stridor are telltale signs of croup. Other clues to the diagnosis are low fever, common cold symptoms, previous bouts of croup, or a history of intubation * or other upper-airway problems. If the symptoms are severe, or if the child does not respond quickly to treatment, a neck X ray may be taken to check for other reasons for the breathing difficulty. The X ray might show a foreign object lodged in the throat or, possibly, epiglottitis * . If the air passage at the top of the trachea is narrowed almost to a point (called a "steeple sign"), it helps confirm the diagnosis of croup.
* larynx (LAIR-inks) is the voice box (which contains the vocal cords) and is located between the base of the tongue and the top of the windpipe.
* stridor (STRY-dor) is a high-pitched, squeaking noise that occurs while breathing in, present usually only if there is narrowing or blockage of the upper airway.
* parainfluenza (pair-uh-in-floo-EN-zuh) is a family of viruses that cause respiratory infections.
* adenovirus (ah-deh-no-VY-rus) is a type of virus that can produce a variety of symptoms, including upper respiratory disease, when it infects humans.
* respiratory syncytial (RES-puh-ruh-tor-e sin-SIH-she-ul) virus, or RSV, is a virus that infects the respiratory tract and typically causes minor symptoms in adults but can lead to more serious respiratory illnesses in children.
* laryngitis (lair-in-JY-tis) is an inflammation of the vocal cords that causes hoarseness or a temporary loss of voice.
* intubation (in-too-BAY-shun) is the insertion of a tube into the windpipe to allow air and gases to flow into and out of the lungs in a person who needs help breathing.
* epiglottitis (eh-pih-glah-TIE-tis) is a condition involving life-threatening swelling of the epiglottis (a soft flap of tissue that covers the opening of the trachea when a person swallows), which is usually caused by a bacterial infection of the epiglottis. The condition can result in a blockage of the trachea and severe breathing difficulty.
Can Croup Be Treated and Prevented?
Mild cases of croup can be treated safely at home. Moist air is especially helpful, and mist from a steam-filled bathroom or cool-mist humidifier will moisten the child's airway, help open the air passage, and relieve coughing. Taking the child outdoors for a few minutes, even in the winter, can ease a coughing attack quickly, because the cool air can shrink the swollen tissues lining the airway. As with most illnesses, drinking fluids and getting plenty of rest help the body heal. Cigarette smoke near a child with croup or any other respiratory illness can make symptoms worse. Doctors advise prompt medical treatment for serious croup infections. Inhaled medications, including epinephrine * , can minimize swelling in the upper airways. Doctors often will administer corticosteroid * medicines to ease airway swelling for a few days while the child recovers from the virus infection that causes croup. There is no way to prevent croup, but frequent hand washing and avoiding contact with people who have respiratory infections can lessen the chance of spreading the viruses that cause croup.
* epinephrine (eh-pih-NEH-frin) is a chemical substance produced by the body that can also be given as a medication to constrict, or narrow, small blood vessels, stimulate the heart, and cause other effects, such as helping to open narrowed airways in conditions like asthma and croup.
* corticosteroids (kor-tih-ko-STIR-oyds) are chemical substances made by the adrenal glands that have several functions in the body, including maintaining blood pressure during stress and controlling inflammation, They can also be given to people as medication to treat certain illnesses.
U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton
Road, Atlanta, GA 30333. The CDC offers information about croup at its
. KidsHealth is a website created by the medical experts of the Nemours
Foundation and is devoted to issues of children's health. It
contains articles on a variety of health topics, including croup.