- Croup is a viral infection that causes airway inflammation, leading to a distinctive "barking" cough and breathing difficulties.
- Symptoms often appear suddenly, tend to worsen at night, and are most common in children aged 1 to 6.
- Treatment depends on severity, ranging from hydration and home care to hospital-administered corticosteroids for significant swelling.
Croup is a respiratory illness caused by a viral infection that inflames the larynx and trachea. This inflammation results in a dry "barking" cough and difficulty breathing due to airway obstruction.
The parainfluenza virus is the primary cause, making the illness most frequent in the fall and early winter among children between 1 and 6 years old. Transmission occurs through contact with infected individuals or via contaminated objects and surfaces.
Treatment follows the pediatrician's guidance, which may involve increased fluid intake, breathing treatments, and the use of corticosteroids. Medical supervision is essential to determine the best course of action for your child.
Main symptoms
The primary symptoms of croup include:
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Difficulty breathing, particularly when inhaling
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A distinctive "barking" cough (often compared to a seal)
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Hoarseness
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A high-pitched whistling sound when breathing (stridor)
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Vomiting caused by excessive coughing, occasionally with mucus
Additionally, some children may experience cold-like symptoms before developing specific signs of croup, such as a sore throat, nasal congestion, cough, and fever.
Symptoms often appear suddenly and tend to worsen at night. In most cases, the condition improves within 3 to 7 days, with the first few nights being the most intense.
Possible causes
The exact cause of croup is not always identified, but it is primarily linked to infection by parainfluenza virus types I, II, III, and IV. Less frequently, it is associated with other viruses such as adenovirus, rhinovirus, influenza A and B, enterovirus, and respiratory syncytial virus (RSV).
Less commonly, croup can result from a bacterial infection by the Staphylococcus or Streptococcus genus, a condition known as bacterial tracheitis.
In rare cases, croup symptoms may stem from respiratory allergies to pollen or dust, epiglottitis, inhaling irritating chemicals, gastroesophageal reflux (GERD), tumors, or inhaling a foreign object.
Croup and COVID-19
Infection with SARS-CoV-2, the virus responsible for COVID-19, can cause inflammation in the upper airways, mimicking the signs and symptoms characteristic of croup. In addition to the typical croup cough, other symptoms may be present, such as fever, runny nose, headache, and excessive fatigue.
Types of croup
Croup is classified into different types based on its cause and characteristics:
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Viral croup: Also known as laryngotracheobronchitis, this is caused by a virus and leads to inflammation of the trachea and bronchi.
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Bacterial croup: Also known as bacterial tracheitis or laryngotracheitis, this is caused by bacteria and can cause inflammation of the trachea and larynx.
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Spasmodic croup: Also known as spasmodic laryngitis, this involves sudden, non-inflammatory swelling of the tissues and does not have an infectious cause.
A pediatrician diagnoses croup by evaluating symptoms and performing a physical exam to check the throat, measure temperature and oxygen levels, and listen to the lungs.
In some cases, the doctor may recommend an X-ray of the neck to check for inflammation in the airway (often looking for the "steeple sign").
Schedule an appointment with the nearest pediatrician for a detailed evaluation of your child's symptoms.
Treatment options
Croup treatment must be directed by a pediatrician and depends on the severity of the symptoms. The main goal is to reduce airway inflammation and keep the child calm.
In mild cases, treatment can be managed at home under medical guidance. It is important to maintain good hydration, avoid dry air and environmental irritants, and create a calm atmosphere that helps the child breathe more easily.
If croup is moderate or severe, treatment should begin immediately at a hospital. This typically involves administering corticosteroids and nebulized epinephrine (breathing treatments), which help reduce airway swelling and rapidly improve breathing.
According to the American Academy of Pediatrics, you should not give cough syrups or cough suppressants without a doctor's recommendation, as these medications can hinder the clearance of mucus and worsen respiratory obstruction, increasing the risk of complications.