Croup
What is croup?Croup is a disease caused by a virus that leads to swelling in
the airways and problems breathing. The child may also have stridor, a
high-pitched sound usually heard when the child breathes in (inspiration).
What causes croup? Croup is caused by a variety of different viruses. The most
common virus is the parainfluenza virus. Other viruses may include:
- respiratory syncytial virus (RSV)
- influenza virus
- measles
- adenovirus
- enteroviruses
A child becomes infected through direct contact with a person, or the
secretions of another person who is infected with the disease. The
infection begins in the upper respiratory tract and then slowly spreads
down the tract. Swelling affects the area around the voice box (larynx)
and into the trachea.
Younger children are more affected by croup because their airways are
smaller. Therefore, a small amount of swelling can cause a large amount of
obstruction in their airways.
Facts about croup:
- Croup is most commonly seen in children 3 months old to 5 years.
- The peak time for croup to occur is 2 years old.
- Boys seem to be more affected by croup than girls.
- Croup is seen more often in the fall and winter.
What are the symptoms of croup? The following are the most common symptoms of croup. However,
each child may experience symptoms differently. As the disease progresses
down the respiratory tract, the symptoms also change and may include:
- a runny nose, congestion, and slight cough
- a cough develops into a "seal's bark"
- laryngitis
- fever
- stridor
Stridor is a high-pitched sound that is usually noted as the child
breathes in (inspiration), although it can also be heard as the child
breathes out (expiration).
Very often, the symptoms are worse at night and wake the child from
sleep. Symptoms also seem to improve in the morning but progress as the
day goes on. The extent of the disease varies for each child. Most
children improve in three to seven days. The symptoms of croup may
resemble other conditions and medical problems. Always consult your
child's physician for a diagnosis.
How is croup diagnosed? In addition to a complete medical history and physical
examination, diagnostic procedures for croup may include:
- neck and chest x-rays - a diagnostic test which uses
invisible electromagnetic energy beams to produce images of internal
tissues, bones, and organs onto film.
- blood tests
- pulse oximetry - an oximeter is a small machine that measures
the amount of oxygen in the blood. To obtain this measurement, a small
sensor (like a Band-Aid®) is taped onto a finger or toe. When the
machine is on, a small red light can be seen in the sensor. The sensor
is painless and the red light does not get hot.
Treatment for croup:Specific treatment for croup will be determined by your child's
physician based on:
- your child's age, overall health, and medical history
- extent of the disease
- your child's tolerance for specific medications, procedures, or
therapies
- expectations for the course of the disease
- your opinion or preference
In severe cases of croup, or if your child is not breathing well,
hospitalization may be considered. This is sometimes hard to tell because
the disease fluctuates, and your child may seem better at one moment, and
then get worse the next. Your child's physician may also order the
following medications to help with the symptoms of croup:
- breathing treatments (to help open up the airways)
- injections of medications (to help decrease the swelling in the
airways)
- steroids given by mouth (to also help with the swelling of the
airways)
Supportive treatment at home may also include:
- using a cool mist humidifier
- taking the child outside into cool, dry, night air
- increased fluid intake
- treating a fever with acetaminophen or ibuprofen, as instructed by
your child's physician
- keeping your child as quiet and calm as possible (to help decrease
the breathing effort)
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