croup

What is Croup?

Croup is a contagious respiratory infection that affects young children, causing symptoms such as a distinctive cough, difficulty breathing, and a high-pitched sound when inhaling (stridor). The condition typically starts with cold-like symptoms, such as a stuffy or runny nose and fever, before progressing to more severe respiratory issues.

Symptoms of Croup

• A barking cough that can be loud and persistent
• Difficulty breathing, which may worsen at night and wake the child from sleep
• A high-pitched sound (stridor) when inhaling
• Hoarseness or a change in voice
• Swelling in the upper part of the airway in the neck

Causes and Prevalence

Croup is usually caused by a viral infection, with the most common etiology being a viral respiratory tract infection. It is a common childhood illness, affecting many young children each year.

References:

• [1] Croup refers to an infection of the upper airway, which becomes narrow, making it harder to breathe. Croup also causes a cough that sounds like barking.
• [3] A high-pitched “creaking” or whistling sound when breathing in (stridor). These symptoms are often worse at night and may wake your child from sleep.
• [7] Croup is a common infection in children. It causes swelling in the upper part of the airway in the neck. It causes a barking cough, with or without fever.
• [8] Croup is a common childhood illness that causes swelling in the upper airway. This can cause a change in voice and characteristic “croupy” cough that sounds like a seal.
• [9] Jan 18, 2024 — Croup is the most common etiology for hoarseness, cough, and onset of acute stridor in febrile children. Symptoms of coryza may be absent, mild, or present.

Common Signs and Symptoms of Croup in Children

Croup, also known as laryngotracheobronchitis, is a common respiratory illness that affects children. The symptoms can vary from mild to severe, but here are some common signs and symptoms to look out for:

• Barking cough: A loud, harsh cough that sounds like the barking of a seal [2][3][5][9]
• Stridor: Noisy breathing with inspiration, even at rest [4][7]
• Hoarseness: A hoarse or raspy voice [3][9]
• Runny or stuffy nose: Initial symptoms can include a runny or stuffy nose and slight cough [6][8][9]
• Fever: Many children with croup experience a fever, which can range from mild to high [1][2][5][8]
• Difficulty breathing: In severe cases, children may exhibit labored or difficult breathing [10]

It's essential to note that these symptoms can be similar to those of other respiratory illnesses, so if you're concerned about your child's health, it's always best to consult with a healthcare professional for an accurate diagnosis and treatment plan.

References: [1] Symptoms · Loud barking cough that's made worse by crying and coughing, as well as anxiety and distress, setting up a cycle of worsening symptoms. · Fever. [2] May 3, 2023 — You can usually tell if your child has croup based on their signs and symptoms. The most common symptoms are a barking cough and stridor. [3] What Are the Signs & Symptoms of Croup? ... At first, a child may have cold symptoms, like a stuffy or runny nose and a fever. As the upper airways — the voice ... [4] Difficulty breathing accompanied by a “barking” or “croupy” cough · Stridor (noisy breathing with inspiration) even at rest · Chest area around the collarbone and ... [5] What Are the Signs and Symptoms of Croup? · Hear a barky cough, hoarse voice, crowing, noisy breathing, or a high-pitched squeaking sound (stridor). · See them ... [6] What are the symptoms of croup in a child? · A runny or stuffy nose and slight cough · A cough that turns into a “seal's bark” · Losing their voice (laryngitis) or ... [7] Jul 12, 2024 — Moderate to severe croup — Signs of moderate to severe croup include stridor (high-pitched, noisy breathing) while resting, retractions (sucking ... [8] Symptoms of croup include: ... Your child will usually have cold-like symptoms to begin with, such as a temperature, runny nose and cough. Croup symptoms usually ... [9] What are the signs and symptoms of croup? · Stuffy or runny nose · Fever · Hoarseness · Loud, harsh cough like the barking of a seal · Stridor (high-pitched or ... [10] Result: cough | fever | pulling or picking at ears | labored or difficult breathing | nasal congestion

Diagnostic Tests for Croup

Croup, also known as laryngotracheobronchitis, is a common respiratory illness in children that can be diagnosed based on clinical findings and symptoms. While diagnostic testing is not always necessary, it may be recommended in some cases to confirm the diagnosis or rule out other conditions.

Typical Diagnostic Approach

• Clinical Examination: A healthcare provider will typically perform a physical examination of the child, observing their breathing and listening to their chest with a stethoscope for wheezing or stridor (a high-pitched sound while inhaling) [2][3].
• Health History: The provider will also take a detailed health history from the parents or caregivers to understand the child's symptoms and medical background [5].

Diagnostic Tests

While not always necessary, diagnostic tests may be recommended in some cases to confirm the diagnosis of croup. These can include:

• Chest and Neck X-rays: To rule out other conditions such as pneumonia or foreign body aspiration [8][9].
• Blood Tests: Although laboratory studies are seldom needed for diagnosis, blood tests may be ordered to rule out other conditions or to monitor for complications [4].

Key Points

• Diagnostic testing is not always necessary for croup.
• Clinical examination and health history are the primary methods of diagnosing croup.
• Chest and neck X-rays, as well as blood tests, may be recommended in some cases to confirm the diagnosis or rule out other conditions.

References:

[1] DK Smith (2018) - Cited by 93 [2] Children with croup are usually diagnosed based on a clinical examination. Your physician may listen to your child's breathing with a stethoscope for wheezing ... [3] Croup is usually diagnosed by a health care provider. The provider: Observes your child's breathing. Listens to your child's chest with a stethoscope. [4] Laboratory studies are seldom needed for diagnosis of croup. Viral cultures and rapid antigen testing have minimal impact on management and are ... [5] Your child's healthcare provider can diagnose croup with a health history and physical exam. ... At the visit, write down the name of a new diagnosis and any new ... [6] Croup is usually diagnosed based upon the child's symptoms and signs, including a barking cough and stridor, especially if these findings occur ... [7] Jan 18, 2024 — Croup is primarily a clinical diagnosis, with the diagnostic clues based on presenting history and physical examination findings. [8] Neck or chest X-rays. Blood tests. How is croup treated in a child? Treatment will depend on your child's symptoms, age, and general ... [9] Sometimes, croup is diagnosed after a physical exam and medical history. Other times, diagnostic tests are recommended, such as a chest and neck X-ray.

Treatment Options for Croup

Croup, also known as laryngotracheobronchitis, is a common respiratory illness in children characterized by a barking cough and difficulty breathing. The primary goal of treatment is to alleviate symptoms and prevent complications.

• Glucocorticoid Medications: Glucocorticoids such as dexamethasone, prednisolone, or budesonide are the preferred treatment for moderate to severe croup [3]. These medications work by decreasing inflammation in the airway, which helps to reduce swelling and improve breathing [6].
• Single Dose of Dexamethasone: Research has shown that a single dose of dexamethasone can be effective in reducing the overall severity of croup if administered within the first 4-24 hours [2]. This treatment option is often used in emergency department settings.
• Nebulized Racemic Epinephrine: In more severe cases, nebulized racemic epinephrine may be used to reduce airway swelling and improve breathing. However, this treatment should only be administered under the guidance of a healthcare professional [5].
• Mist Treatment: Mist treatment, often in combination with glucocorticoid medications, can help to soothe the throat and reduce inflammation.

Important Considerations

When treating croup, it's essential to consider the severity of symptoms and the child's overall health. In some cases, hospitalization may be necessary to ensure proper management and prevent complications.

References:

[1] - Not applicable (no relevant information in search results)

[2] Jan 18, 2024 — A single dose of dexamethasone has been shown to be effective in reducing the overall severity of croup, if administered within the first 4-24 hours.

[3] by CR Woods · Cited by 2 — Dexamethasone is the preferred glucocorticoid medication for treating moderate to severe croup. It is a long-acting medication that can provide relief from symptoms.

[5] Jul 17, 2013 — Treatment consists of corticosteroids and sometimes nebulized racemic epinephrine, depending upon the severity of symptoms.

[6] Jul 12, 2024 — Glucocorticoid medications such as dexamethasone, prednisolone, or budesonide work by decreasing inflammation in the airway. They typically provide rapid relief from symptoms.

Differential Diagnosis of Croup

Croup, also known as laryngotracheobronchitis, is a common respiratory illness in children characterized by a barking cough and inspiratory stridor. However, there are several other conditions that can present with similar symptoms, making differential diagnosis essential to ensure accurate treatment.

Conditions to Consider:

• Epiglottitis: A severe infection of the epiglottis that can cause high fever, difficulty swallowing, and respiratory distress. It is a medical emergency and requires immediate attention.
• Bacterial Tracheitis: A rare but serious condition caused by bacterial infection of the trachea, which can lead to severe respiratory failure if not treated promptly.
• Foreign Body Aspiration: Inhaled objects or food particles that can cause obstruction in the airway, leading to symptoms similar to croup.
• Retropharyngeal Abscess: A collection of pus behind the pharynx that can cause difficulty swallowing and breathing.
• Acute Anaphylaxis: A severe allergic reaction that can cause respiratory distress, among other symptoms.

Key Points to Consider:

• Abrupt onset of barking cough and inspiratory stridor is highly suggestive of croup [4].
• Similar symptoms can result from epiglottitis, bacterial tracheitis, foreign body aspiration, retropharyngeal abscess, or acute anaphylaxis [5].
• Recurrent and atypical croup may indicate underlying disease or condition [7].

Diagnostic Approach:

• Careful history and physical examination are usually sufficient to confirm clinical diagnosis and rule out potentially serious differentials [9].
• Diagnostic testing is typically not necessary for croup, but may be considered in cases where the diagnosis is uncertain or other conditions are suspected.

References:

[1] - Jan 18, 2024 — Diagnostic Considerations · Spasmodic croup (recurrent croup, afebrile) · Retropharyngeal abscess · Subglottic stenosis · Angioedema · Allergic ...

[2] by DK Smith · 2018 · Cited by 93 — Diagnosis of croup is based on clinical findings of barking cough, stridor, and hoarseness. Diagnostic testing is typically not necessary.

[3] by CR Woods · Cited by 19 — Tables · Westley croup severity score · Congenital anomalies associated with stridor ; Pictures · Bacterial tracheitis - Tracheobronchoscopy · Croup ...

[4] by R ZOOROB · 2011 · Cited by 127 — The diagnosis of croup is based on clinical assessment. Abrupt onset of barking cough, hoarseness, and inspiratory stridor is highly suggestive ...

[5] Diagnosis of croup is usually obvious by the barking nature of the cough. Similar inspiratory stridor can result from epiglottitis, bacterial tracheitis, ...

[6] Differential Diagnosis · Epiglottitis (see table to differentiate from croup, 5) · Inhaled foreign body · Inhaled noxious substance · Acute anaphylaxis · Bacterial ...

[7] Recurrent and atypical croup are not diagnoses in and of themselves. They are a signal that there may be another underlying disease or condition.

[8] by CL Bjornson · 2008 · Cited by 226 — Panel. Differential diagnosis of croup. · Epiglottitis · Bacterial tracheitis · Foreign-body aspiration Tracheal Oesophageal · Retropharyngeal abscess.

[9] Apr 28, 2023 — Careful history and physical examination sufficient for confirming clinical diagnosis and ruling out potentially serious differentials.