What is croup?
Croup is a viral infection that usually affects children between the ages of three months to five years. Symptoms are most severe in children under three years of age and croup is more common among males. In most cases, croup follows an upper respiratory infection. The virus most commonly involved is the Parainfluenza virus (accounting for about 75% of cases). This illness is most often seen in the fall and winter during the cold season. Croup tends to reoccur during childhood, but attacks disappear as the child grows.

What are the symptoms of croup?
Common symptoms of croup include a low grade fever, a brassy, “barking� or “seal-like� cough, a hoarse cry, inspiratory stridor, (a harsh, vibrating sound when your child breathes in) and difficulty breathing. These symptoms are caused by swelling and muscle spasms in the throat and windpipe. Symptoms usually appear in the early evening and worsen through the night. Croup may last from 5 to 6 days. Parents should expect a complete recovery.

Treatment of croup at home.
In most cases, croup can be treated effectively at home. Treatment with cool mist will relieve some of the distress of croup. Cool mist is effective in reducing fever, reducing the swelling in the airway, and liquefying mucus secretions in the airway for easy expectoration.
Another option may be to run a hot shower or tub water in the bathroom with the door closed for fifteen minutes or so. This creates an environment high in humidity to relieve the coughing and other symptoms associated with croup.

Taking the child into the cool outside air for about fifteen minutes also seems to break the episode of spasmodic croup, because it reduces airway swelling. Freezer air may do if it is a warm night.

The child should receive adequate rest and drink plenty of fluids. Because crying increases respiratory distress, care should be taken to comfort and soothe the child.

It is very important to closely monitor a child with croup. Parents should be aware of signs of increasing airway obstruction and seek medical care if the child is experiencing respiratory distress. If the child experiences continuous respiratory stridor, retraction (skin sinking in) around the neck or ribs, or severe breathing difficulty, it is important to seek prompt medical care.

When to call your child’s doctor.
Immediately call your physician if your child has ANY of the following:
Difficulty breathing
Continuous stridor
Drooling or difficulty swallowing
Difficulty bending the neck
Decreased consciousness
High fever
Very sick appearance
Or other worrisome signs

Medical Management of Croup
Treatment of croup in the doctor’s office or hospital is similar to treatment at home. Cool mist therapy in a croup tent will help relieve some of the distress of croup symptoms. Inhaled medications and/or oral corticosteroids may be prescribed to decrease the swelling and spasm of the upper airway. Because croup is a viral infection, antibiotics are generally not used.