Croup in Children – Symptoms, Diagnosis and Treatment

Croup is an infection of the breathing airways of the child. Children with croup develop swelling of the voice box (larynx), windpipe (trachea) and bronchial tubes (bronchi). Croup leads to fever, cough and breathing difficulty.

What is the cause of croup in children?
The most common cause of croup in children is viral infections. The most common virus leading to croup is parainfluenza virus. Croup might also be caused by other microorganisms like bacteria. Gastroesophageal reflux and allergies are also known non-infectious causes of croup in children.

Croup in Children - Symptoms, Diagnosis and treatment

What Are the Symptoms of Croup?
The symptoms of croup start with a runny or a blocked nose, cough and fever. This is followed by change in the child’s voice which becomes horse and barky in nature and appearance of a harsh sound during breathing known as stridor. This happens because of the swelling of the voice box, also known as the larynx. Children also develop a whistling sound in the airway, also called wheezing. This happens because of the swelling of the lower airways, also known as the bronchi. If the swelling of the airways is severe enough the child can develop difficulty in breathing. Some children can also develop low oxygen levels. Symptoms of croup are usually worse at night and when the child is agitated or crying.

How is Croup treated?
Most cases of viral croup are mild in nature and can be usually treated at home. Children with moderate to severe disease require hospital admission. Some children might require admission to a pediatric intensive care unit.

Treatment of croup requires maintaining hydration of the child with extra fluids, keeping the child calm and controlling fever with paracetamol. Children with moderate to severe croup requiring hospital admission need supplemental oxygen to maintain their blood saturations above 92 to 93%. Vital monitoring of children is extremely important to decide for further treatment.

Children with croup usually require two types of medicines.

  • Steroids are often used to reduce the amount of swelling in the airways. Steroids can be used as nebulizer, oral syrup or injection. The most commonly used steroids for treatment of croup is dexamethasone.
  • Nebulization with racemic epinephrine, also called as adrenaline is extremely useful and helps in reduction of airway swelling.

If your child is getting symptoms suggestive of croup get in touch with a pediatric pulmonologist for further guidance regarding diagnosis and treatment.

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