Croup in Children: Symptoms, Diagnosis, and How to Treat and Prevent

Child Coughs Loudly? Beware of Croup

Croup (Acute laryngotracheobronchitis) is an acute upper respiratory infection, common in young children. It's usually caused by a virus, leading to inflammation and swelling from the larynx to the small bronchi. This results in a barking cough. abnormal breathing sounds, and even breathing difficulties.

Causes of Croup

Viral Infection
Accounts for 75-80% of cases. Common viruses include Parainfluenza, Influenza, RSV, Adenovirus, Coronavirus, and Metapneumovirus.
Bacterial Infection
Less common but more severe than viral causes.
Non-infectious Causes
Includes allergies or irritation from chemicals.

What Are the Symptoms of Croup?

Is your child showing signs of croup? Look for the following symptoms:
• Barking cough, especially at night
• Stridor (noisy breathing when inhaling)
• Hoarseness
• Cold-like symptoms 1-3 days prior: fever, runny nose, nasal congestion, sore throat
• Severe cases may include difficulty breathing, cheat retraction, bluish hands/feet, and lethargy

How Is Croup Diagnosed?

Clinical History and Physical Exam
Key signs include barking cough and stridor. The throat may show red, swollen epiglottis.

Additional Tests
• Chest/neck X-ray may show the "steeple sign"-narrowing of the upper airway
• Oxygen saturation to assess severity
• Nasopharyngeal swab to detect viral causes such as influenza

How Is Croup Treated?

Supportive Care
• Elevate the child's head while resting
• Use a humidifier or add moisture to the air
• Offer warm fluids and adequate hydration
• Keep the child calm and rested
• Use fever reducers if needed
• Oxygen therapy or intubation in severe respiratory distress

Medications

• Steroids (oral, inhaled, or injectable) to reduce airway inflammation-first-line treatment

• Nebulized epinephrine for temporary relief in severe cases
Most children recover within 3-7 days. However, the cough may persist for 1-2 weeks.
Possible complications include airway obstruction, secondary bacterial infections, dehydration, and electrolyte imbalance. Infants or immunocompromised children may develop more severe symptoms.

How to Prevent Croup

• Practice proper hand hygiene
• Influenza vaccination helps reduce severity
• Avoid close contact with infected individuals

 

 

Reference :

Synphaet Children Hospital Croup in Children: Symptoms, Diagnosis, and How to Treat and Prevent

ArokaGO Providers Synphaet Children Hospital