Croup, also called laryngotracheobronchitis (pronounced as laryn-go-tra-cheo-bronchitis,) is an infection of the upper airways that interfere with proper breathing and cause it characteristic symptom called barking cough. The upper airways are made up of :
- Nose and nasal passages.
- Paranasal sinuses.
- Pharynx (throat).
- Part of the Larynx (voice box)
The function of the upper airways:
- It provides passage of air to the lungs and out.
- Conditioning and cleaning of the air going into the lungs
- Formation of sound produced by the vocal cords
Croup is a common condition that affects 15% of children and commonly occurs between six months and five years of age but rare in children above 15 years of age. It is seen mostly in males than in females.
How is croup caused?
Croup is mainly caused by parainfluenza and influenza viruses. These viruses cause the inside of the trachea to swell and interfere with normal breathing. In rare cases, croup is caused by a bacteria.
Other causes of croup are:
- Respiratory syncytial virus.
- Corynebacterium diphtheriae: used to be the major cause of bacteria croup and very fatal. Bacteria Croup caused by diphtheria is no longer common due to the presence of vaccine
- Staphylococcus aureus
- Streptococcal pneumoniae
- Moraxella catarrhalis
What Are The Signs And Symptoms Of Croup:
These signs can be mild, moderate, or severe, and they often start at night or get worse at night, and the symptoms will last for one or two days. The signs and symptoms are:
- Barking cough
- Voice becomes hoarse
- Stridor (high pitched breath sounds, noisy turbulent airflow) that gets worse with crying or anxiety.
- High temperature (fever).
- Runny nose.
- Stuffy nose.
- Dyspnea (difficulty in breathing) that gets worse at night.
- Sore throat
- Problems with consciousness in severe cases of croup
- Loss of appetite.
How Is Croup Diagnosed?
- Physical examination (inspection of the chest area, percussion, and auscultation of lungs)
- Blood analysis.
- Frontal X-ray of the neck: shows the narrowing of the trachea, which is also referred to as steeple sign.
- Viral culture (from secretion gotten from nasopharyngeal aspiration)
- Chest X-ray to rule out lungs involvement
What is the best thing to do for croup?
Croup usually lasts for a maximum of 5 days, some cases do not require hospitalization, while some cases do (1 in 5 cases are hospitalized). Antiviral medications are not required to treat croup. The best thing to do are:
- Use of humidifier ( to help your child breathe freely)
- Steam inhalation.
- Drink plenty of fluids (more water)
- Acetaminophen for fever.
- Take Ibuprofen
- Take oral corticosteroid medication (Dexamethasone or Budesonide or Prednisolone) If croup symptoms persist or worsen
- Nebulized Epinephrine.
- Good rest.
- Oxygen therapy in severe cases.
Note: If your child has breathing problems or difficulty swallowing saliva, they may need emergency hospital treatment.
How to prevent croup?
Croup is usually caused by viruses that are spread through airborne means of transmission. The infections can be prevented by:
- Taking Influenza vaccine.
- Taking the Diphtheria vaccine
- Washing hands after touching any surfaces to prevent the spread of infection.
- Using a mask when sharing a living space with a sick person with influenza.
- Avoid crowded environment
- Croup lasts for a period of 5days and affects male children more than females.
- It can be successfully managed with steroids and epinephrine.
- Antibiotics are not used unless it is bacteria croup or croup complicated by a secondary bacterial infection.
- Croup is mostly preventable.
- Cough medicines are not recommended for croup because they do not improve the disease.