Croup facts for kids

Croup (also known as laryngotracheobronchitis) is a common illness that affects children. It's caused by a virus and makes the inside of the throat swell up. This swelling makes it hard to breathe normally.

Kids with croup often have a special "barking" cough. It can sound a bit like a seal or sea lion. They might also make a high-pitched whistling sound when they breathe in. This sound is called stridor. Their voice can also become hoarse. Croup symptoms often get worse at night.

Doctors can usually tell if someone has croup by their symptoms. They also check to make sure it's not another problem. Croup is very common in young children. About 15% of kids between 6 months and 5–6 years old get it. Teenagers and adults rarely get croup.

What are the Signs of Croup?

Croup symptoms include a "barking" cough, a high-pitched sound when breathing in (stridor), and a hoarse voice. These symptoms often get worse at night. Crying can make the stridor sound louder. This is because crying can narrow the airways even more.

Other signs of croup can be a fever and symptoms like a common cold. You might also see the skin between a child's ribs pull in when they breathe. This means they are working hard to get air. If a child is drooling or looks very sick, it might be a different illness. The virus causes swelling in the throat and air passages, which makes breathing difficult.

What Causes Croup?

Most cases of croup are caused by a virus infection. The most common virus is the parainfluenza virus. Other viruses that can cause croup include influenza (the flu), measles, and respiratory syncytial virus (RSV).

Sometimes, croup can be caused by bacteria. These types of croup are usually more serious. They can happen after a virus infection. Common bacteria that cause croup include Staphylococcus aureus and Streptococcus pneumoniae.

How Do Doctors Diagnose Croup?

Doctors diagnose croup based on the child's symptoms. They first make sure it's not another condition that could block the airway. For example, they check for epiglottitis (swelling of the flap that covers the windpipe) or something stuck in the airway.

An X-ray of the neck is not always needed. But if one is done, it might show a narrowing of the windpipe. This narrowing is sometimes called the steeple sign. It looks a bit like a church steeple. However, this sign doesn't show up in half of croup cases.

Blood tests are usually not needed. They can sometimes upset the child and make their breathing worse.

How Severe is Croup?

Doctors use a system called the Westley score to describe how severe croup is. This score helps doctors in studies, but it doesn't usually change how a child with croup is treated.

• Mild croup: The child has a barking cough and hoarseness. There is no stridor (wheezing) when they are resting.
• Moderate croup: The child has wheezing, even when resting.
• Severe croup: The child has clear wheezing. The skin on their chest wall pulls in a lot when they breathe.
• Very severe croup: This means breathing trouble is possible. The barking cough and wheezing might not always happen at this stage.

Most children who go to the emergency room with croup have a mild form of the illness. Severe croup is rare.

Can Croup Be Prevented?

Yes, some types of croup can be prevented. Getting vaccines for influenza (the flu) and diphtheria can help protect against croup.

How is Croup Treated?

It's very important to keep children with croup as calm as possible. Being upset can make their breathing worse.

Doctors often give children with croup steroids. Steroids help reduce the swelling in the throat. In more severe cases, a medicine called epinephrine might be used. If a child's blood oxygen level is low, they might need oxygen.

Children with severe croup might need to stay in the hospital for a short time. If oxygen is needed, doctors often hold the oxygen source near the child's face. This is called "blow-by" oxygen. It's usually better than an oxygen mask because it's less likely to upset the child. With good treatment, very few children need a breathing tube placed in their airway.

Steroid Medicines

Corticosteroids, like dexamethasone, are often used to treat croup. Children usually start to feel much better within six hours after taking steroids. Steroids can be given by mouth, injection, or by breathing them in. Taking them by mouth is usually the easiest way. Often, just one dose is enough.

Epinephrine Medicine

For moderate to severe croup, doctors might use nebulized epinephrine. This is a liquid medicine that the child breathes in as a mist. Epinephrine helps open the airways quickly, usually within 10–30 minutes. However, its effects only last for about 2 hours. If a child improves for a few hours after treatment and has no other problems, they can usually go home.

Other Treatments

Other treatments for croup are not usually helpful. Breathing hot steam or humid air is not proven to work and is rarely used now. Doctors do not recommend using cough medicines for croup. Since most croup is caused by viruses, antibiotics are not used unless a bacterial infection is also suspected.

What is the Outcome of Croup?

Most of the time, croup caused by a virus is a short-term illness. It usually gets better on its own. Symptoms often improve within two days, but they can last for up to seven days. It's very rare for croup to cause serious problems like breathing failure.

Other rare problems can include a bacterial infection of the windpipe (trachea) or a lung infection (pneumonia).

Who Gets Croup?

Croup is quite common in young children. About 15% of kids between 6 months and 5–6 years old will get it. It's also a common reason for children in this age group to be admitted to the hospital. Rarely, babies as young as 3 months and children as old as 15 years can get croup. Boys get croup more often than girls. Croup is also more common in the autumn (fall) months.

History of Croup

The word croup comes from an old English word meaning "to cry hoarsely." This name was first used for the disease in Scotland.

People have known about croup for a very long time. In 1826, a doctor named Bretonneau realized there were two types of croup. One was caused by a virus, and the other was caused by a bacteria called diphtheria. In the past, croup caused by diphtheria was very serious. But now, it's almost unheard of because most people get vaccinated against diphtheria.

See also

In Spanish: Laringotraqueobronquitis para niños