What is viral croup?

Viral croup, or laryngotracheobronchitis, is characterized by inspiratory stridor, barking cough, and hoarse voice caused by inflammation of the larynx and subglottic airways. The main causative agents are viruses, with parainfluenza virus accounting for about 75%. Rhinovirus, influenza, and adenovirus can also cause this disease. It is common in children under six years old, especially in children six months to 3 years old.

What are the symptoms of viral croup?

Initial symptoms are a runny nose and stuffy nose, progressing over 12 to 48 hours to fever, hoarseness, barking cough, and inspiratory stridor. The symptoms are usually worse at night. If airway obstruction worsens, severe difficulty breathing may occur. Viral croup is usually a self-limiting illness that is resolved within three days, but the cough may persist for a week.

Treatment and Care

• Children with mild symptoms (no stridor at rest and no respiratory distress) can be treated at home with parents/caregivers providing supportive care (reducing fever and encouraging fluid replacement) and administering medications as prescribed by the outpatient/emergency physician.
• In children with severe croup, irritability, and crying may aggravate airway obstruction. Parents/caregivers can hold and comfort the child to minimize agitation.
• Children with severe croup need to be kept in the emergency department or hospitalized and treated with steroids and inhaled medications to reduce airway edema and relieve respiratory distress.

Please pay attention to your child’s symptoms and go to the emergency department as soon as possible if the child:

• Has a very hard time breathing
• Starts to turn blue or very pale
• Can't speak or cry because they can't get enough air
• Seems very sleepy or does not seem to respond to you