Croup
Definition
Croup is a term that describes inflammation of the voice box and larynx typically caused by a viral infection. This swelling makes breathing sound noisy and gives the cough a hoarse or "barky" characteristic. Croup is most common between 3 months and 5 years of age and is more prevalent during the fall and winter months. Croup can be associated with a tight, coarse whistling noise upon inspiration, called stridor.
Mild Croup
Presentation
- Mild croup typically presents like a common cold, with or without fever, and a hoarse cry or barky cough in the evening or early morning hours. The cough can improve or disappear during the day, only to return again at night.
- Children with mild croup don't show signs of respiratory distress and are able to feed and breathe normally.
- They may have stridor with activity or when upset/crying but not at rest.
Management
- Fever reduction (if fever is present)
- Oral fluids
- Humidification (i.e. steamy shower)
- Exposure to cold night air
Moderate/Severe Croup
Presentation
- Croup cough is more persistent and may not follow a day/night pattern.
- Child presents with stridor at rest.
- Child presents with other signs of respiratory distress.
- Cough may begin to either wear your child out or produce anxiety/agitation.
Management
- Fever reduction (if fever is present)
- Oral fluids
- Humidification (i.e. steamy shower)
- Exposure to cold night air
- Keeping your child as calm as possible
When should you seek help?
Contact Modern Pediatrics for
- Stridor at rest without severe respiratory distress or agitation
- Severe coughing spells
- Worsening course
- Prolonged symptoms
Call 911 or head to the emergency department for
- Marked retractions
- Struggling to catch breath or difficulty speaking/making verbal sounds
- Color change, including pale skin or bluish lips/fingernails
- Child appears anxious/agitated OR lethargic/listless
- Excessive drooling or difficulty swallowing secretions
- Needing to lean forward with neck extended to breathe