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What is croup?

Croup ( Laryngotracheobronchitis ) is a group of respiratory diseases that often affects infants and children under age 6. It is characterized by a barking cough; a whistling, obstructive sound ( stridor ) as the child breathes in; and hoarseness due to obstruction in the region of the larynx. It may be mild, moderate or severe, and severe cases, with breathing difficulty, it is fatal if not treated in a hospital

Symptoms

Croup is characterized by a harsh "barking" cough and sneeze, aspiratory stridor ( a high-pitched sound heard on inhalation ), nausea/vomiting, and fever. Hoarseness is usually present. More severe cases will have respiratory distress.

The " barking " cough ( often described as seal-like ) of croup is diagnostic. Stridor will be provoked or worsened by agitation or crying. If stridor is also heard when the child is calm, critical narrowing of the airway may be imminent.

In diagnosing croup, it is important for the physician to consider and exclude other causes of shortness of breath and stridor, such as foreign body aspiration and epiglottitis.

Etiology

The parainfluenza viruses ( I, II, III ) are responsible for as many as 80 % of croup cases, with parainfluenza I accounting for most episodes and for 50-70 % of hospitalizations.

What is it treated?

Even though your child's coughing and troubled breathing can be frightening, home treatment usually eases the symptoms.

Try to stay calm during an attack, and soothe your child. Crying can make the swelling in the windpipe worse and make it even harder to breathe.

Breathing in moist air seems to help during a croup attack. Fill your bathroom with steam from the hot water faucets, and sit in the room with your child for 10 minutes. Or hold your child directly over a humidifier, and let the vapor blow directly in his or her face.

Breathing cool night air also seems to help sometimes. Dress your child in warm clothes, and go outside for 10 minutes.

If symptoms improve with these methods, put your child back in bed with the humidifier blowing nearby. Do not smoke, especially in the house. If the symptoms happen during the middle of the night, it is a good idea to sleep in or near your child's room until morning.

It is important to keep your child well hydrated. Offer water, flavored ice treats ( such as Popsicles ), or crushed ice drinks several times each hour.

If your child’s symptoms don't get better after 30 minutes, call or see your doctor. If the attack is in the middle of the night and you are very worried, consider taking your child to the emergency room.

If your child has severe difficulty breathing, call 911or other emergency services immediately.

If your child has severe croup or has not responded to home treatment, medicines may be used to decrease airway swelling. These are usually given in a doctor's office or an emergency room. In rare cases, a child needs to stay in the hospital for treatment.