Croup | |
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Other names | Croupy cough, subglottic laryngitis, obstructive laryngitis, laryngotracheobronchitis |
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The steeple sign as seen on an AP neck X-ray of a child with croup | |
Pronunciation | |
Specialty | Pediatrics |
Symptoms | "Barky" cough, stridor, fever, stuffy nose[2] |
Duration | Usually 1–2 days but can last up to 7 days[3] |
Causes | Mostly viral[2] |
Diagnostic method | Based on symptoms[4] |
Differential diagnosis | Epiglottitis, airway foreign body, bacterial tracheitis[4][5] |
Prevention | Influenza and diphtheria vaccination[5] |
Medication | Steroids, epinephrine[4][5] |
Frequency | 15% of children at some point[4][5] |
Deaths | Rare[2] |
Croup, also known as Croupy cough, is a type of respiratory infection that is usually caused by a virus.[2] The infection leads to swelling inside the trachea, which interferes with normal breathing and produces the classic symptoms of "barking/brassy" cough, inspiratory stridor and a hoarse voice.[2] Fever and runny nose may also be present.[2] These symptoms may be mild, moderate, or severe.[3] Often it starts or is worse at night and normally lasts one to two days.[6][2][3]
Croup can be caused by a number of viruses including parainfluenza and influenza virus.[2] Rarely is it due to a bacterial infection.[5] Croup is typically diagnosed based on signs and symptoms after potentially more severe causes, such as epiglottitis or an airway foreign body, have been ruled out.[4] Further investigations, such as blood tests, X-rays and cultures, are usually not needed.[4]
Many cases of croup are preventable by immunization for influenza and diphtheria.[5] Most cases of croup are mild and the patient can be treated at home with supportive care. Croup is usually treated with a single dose of steroids by mouth.[2][7] In more severe cases inhaled epinephrine may also be used.[2][8] Hospitalization is required in one to five percent of cases.[9]
Croup is a relatively common condition that affects about 15% of children at some point.[4] It most commonly occurs between six months and five years of age but may rarely be seen in children as old as fifteen.[3][4][9] It is slightly more common in males than females.[9] It occurs most often in autumn.[9] Before vaccination, croup was frequently caused by diphtheria and was often fatal.[5][10] This cause is now very rare in the Western world due to the success of the diphtheria vaccine.[11]
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