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Welcome, eCureMe.com medical contents search April 25, 2013
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Croup


Viral laryngotracheobronchitis, acute spasmodic laryngitis (spasmodic croup)



  • Croup is the description given to a "barking" cough, which generally results from infection, inflammation, and swelling in the upper airways.  This leads to breathing difficulties.
  • It usually occurs in children between 6 months and 3 years of age, in fall and winter.

  • "Barking" or hoarse cough
  • Stridor (whistling/wheezing sound in the neck)
  • Restlessness
  • Fever
  • Nasal flaring with breathing
  • Blue lips and skin in severe cases
  • Breathing difficulties
  • Suprasternal, infrasternal, and intercostal retractions
  • Rapid heart beat
  • Pallor
  • Cool and moist skin

  • Respiratory syncytial virus (RSV)
  • Influenza virus
  • Hamophilus Influenza bacteria
  • Parainfluenza virus
  • Adenoviruses
  • Enteroviruses
  • Mycoplasma pneumoniae

  • Examination:
    1. Chest -- prolonged inspiration and expiration, wheezing, and decreased breath sounds
    2. Throat -- red epiglottis (this exam must be undertaken cautiously by a physician)
  • Subglottic narrowing may be seen in the neck X-ray

  • Mild cases caused by viruses:

    1. Warm or cold humidified air
    2. Cold outside air sometimes helps
  • Bacterial causes -- needs antibiotic treatment, e.g., Augmentin
  • Oxygen administration
  • Topical inhaled steroid Budesonide
  • Intramuscular Dexamethasone
  • Nebulized racemic epinephrine
  • Intubation or tracheostomy can be necessary.


  • The usual duration is 3-7 days.
  • Recurrences are frequent between 3 and 6 years of age.

  • Croup can be mild or very severe.  Contact your physician early if you have any doubts about the seriousness of the case.  Any respiratory distress or suspicion of foreign body aspiration needs immediate emergency medical attention.
  • If your child has any of the following symptoms, he or she needs immediate emergency medical attention:
    1. Suspected Epiglottitis
    2. Progressive noisy inspiration, or severe noisy inspiration.
    3. Breathing difficulties
    4. Restlessness
    5. Blue lips and skin
    6. Pallor
    7. High fever in a toxic-appearing child
    8. Changes in consciousness



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