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