Causes, incidence, and risk factors
Croup is usually caused by a virus, but can also be triggered by bacteria, allergies, acid reflux, and inhaled irritants.
Most commonly, children between ages 3 months and 5 years are affected, but it can occur at any age. Although it is more common in the winter months, croup can occur at any time of the year.
Symptoms and Signs
Croup has a distinct “seal bark-like cough.” It usually presents at night and may be preceded by several days of cold symptoms. Croup can last up to 5 or 6 days, but symptoms are most severe in the first night or two. Some children may have a fever as well.
Children with croup are usually diagnosed based on the parent's description of the symptoms and a physical exam. During the physical exam, the doctor may see chest retractions, hear wheezing or notice other forms of breathing difficulty. Sometimes a chest x-ray is needed.
Treatment of croup is usually supportive in nature. One can manage the child at home. Either cool or moist air may initially help stop the cough. Doctors will recommend taking the child outside or steaming up a bathroom and having the child breathe in the air. Also, one may try a cool mist vaporizer to alleviate symptoms.
If the child is seen in the office, a short course of steroid or inhaled aerosol treatment may be prescribed. Call your doctor if symptoms are not improving with supportive measures.
Although most cases of croup can be easily managed at home, some complications may arise. Depending on the severity of the symptoms, call 911 or your health care provider for any of the following
- Respiratory distress
- Atelectasis (collapse of part of the lung)
- The croup is possibly being caused by an insect sting or inhaled object
- The child has bluish lips or skin color
- The child is drooling
- The child is having trouble swallowing
- Stridor (noise when breathing in)
- Retractions (tugging-in between the ribs when breathing in)
- Struggling to breathe
- Agitation or extreme irritability
- Not responding to home treatment
If any of the above symptoms are noted, seek immediate medical attention.
Do NOT wait until the morning.