CROUP

(Laryngotracheobronchitis)

 Basic information

description

Croup is an infection that causes redness and swelling of the larynx (vocal cords). It may extend into the trachea (windpipe) and bronchi (airways in the lungs). Children under age 5 are most often affected.

FREQUENT SIGNS & SYMPTOMS

• The infection can start gradually with a cold, cough, and low fever. Frequently, symptoms come on suddenly in the middle of the night.
• Barking cough. It may be worse when child cries.
• Trouble breathing, especially at night.
• Noisy breathing or wheezing (called stridor).
• Hoarseness.
• Throat discomfort with difficulty in swallowing.
• More severe symptoms include fast breathing, ribs that seem to pull in when breathing, paleness, and bluish skin around the mouth.

causes

A contagious, viral infection is the usual cause. Croup often occurs in outbreaks in the winter and early spring months. Symptoms may begin 3 to 5 days after exposure, but time will vary depending on the type of virus.

risk increases with

• Repeated colds and lung infections or lung disease.
• Previous croup or family history of croup.
• Younger than age 3.

PREVENTIVE MEASURES

No specific preventive measures. Wash your hands often to prevent the spread of any germs.

expected outcomes

Croup can be frightening, because attacks usually happen at night and the child has trouble breathing. In almost all cases, croup is not serious and clears up in about a week or less. Complications are rare, but they may occur in children born prematurely or children with lung disease such as asthma.

possible complications

• Recurrence of croup .
• Ear infection.
• Pneumonia .
• Lymph node inflammation .
• Rarely, a blocked airway (requires hospital care).

 diagnosis & treatment

general measures

• If symptoms are more severe or you are concerned about the symptoms, see your child's health care provider. A physical exam is usually all that is needed for diagnosis.
• A child who has severe breathing problems may need hospital care. Oxygen may be given to help breathing.
• Most children can be treated at home using supportive care. There are no specific drugs to treat croup.
• Turn on the hot water in the bathroom shower and let the room fill with steam. Hold the child in your arms in the bathroom filled with steam for 10 to 15 minutes. Repeat this procedure if another attack occurs.
• Wrapping the child in a blanket and walking around outdoors may help. It is better if outdoor air is cool.
• Keep the child comfortable in a semi-seated position. Use TV, radio, or a story to distract the child so he or she can relax. Crying can aggravate symptoms.
• Use a cool-mist humidifier or vaporizer near the child's bed for several nights during and after an attack even if the child appears well. Simple croup can recur. Clean the humidifier daily.

medications

• Since the cause is usually viral, antibiotics do not help. Cough medicines are also not helpful.
• Acetaminophen may be given to lower fever .
• Injected drugs may be given to a child in the hospital.
• Steroids and/or bronchodilators (to help open the airways) may be prescribed.

activity

Rest until symptoms improve.

diet

Usually, a child with croup is not as hungry as normal. It is important to drink plenty of fluids. Offer frequent small amounts of clear fluids or Popsicles.

 notify our office if

• Your child is having trouble breathing and cannot swallow saliva or water. This is an emergency! Call 911 or take the child to the nearest emergency room.
• Nails or lips become bluish.
• Mild croup symptoms don't improve with home care.

Special Notes: