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| {{Infobox_Disease
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| | Name = Croup
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| | Image =
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| | Caption =
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| | DiseasesDB = 13233
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| | ICD10 = {{ICD10|J|05|0|j|00}}
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| | ICD9 = {{ICD9|464.4}}
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| | ICDO =
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| | OMIM =
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| | MedlinePlus = 000959
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| | eMedicineSubj =
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| | eMedicineTopic =
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| | eMedicine_mult =
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| | MeshID =
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| }}
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| {{Croup}} | | {{Croup}} |
| | | {{About1|Human parainfluenza virus}} |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| {{CMG}} | | {{CMG}} {{AE}} {{LRO}} |
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| | {{SK}} Tracheolaryngobronchitis; laryngotracheobronchitis; laryngo-tracheo-bronchitis; croup syndrome; barking cough; acute laryngotracheitis |
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| ==[[Croup overview|Overview]]== | | ==[[Croup overview|Overview]]== |
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| ==[[Croup pathophysiology|Pathophysiology]]== | | ==[[Croup pathophysiology|Pathophysiology]]== |
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| ==[[Croup epidemiology and demographics|Epidemiology & Demographics]]== | | ==[[Human parainfluenza virus|Causes]]== |
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| ==[[Croup risk factors|Risk Factors]]== | | ==[[Croup classification|Classification]]== |
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| ==[[Croup screening|Screening]]== | | ==[[Differentiating croup from other diseases|Differentiating Croup from other Diseases]]== |
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| ==[[Croup causes|Causes]]== | | ==[[Croup epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==[[Croup differential diagnosis|Differentiating Croup]]== | | ==[[Croup risk factors|Risk Factors]]== |
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| ==[[Croup natural history|Complications & Prognosis]]== | | ==[[Croup natural history, complications, and prognosis|Natural History, Complications and Prognosis]]== |
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| ==Diagnosis== | | ==Diagnosis== |
| [[Croup history and symptoms|History and Symptoms]] | [[Croup physical examination|Physical Examination]] | [[Croup staging|Staging]] | [[Croup laboratory tests|Laboratory tests]] | [[Croup electrocardiogram|Electrocardiogram]] | [[Croup x ray|X Rays]] | [[Croup CT|CT]] | [[Croup MRI|MRI]] [[Croup echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Croup other imaging findings|Other images]] | [[Croup other diagnostic studies|Alternative diagnostics]] | | [[Croup history and symptoms|History and Symptoms]] | [[Croup physical examination|Physical Examination]] | [[Croup laboratory findings|Laboratory Findings]] | [[Croup x ray|X Ray]] | [[Croup other diagnostic studies|Other Diagnostic Studies]] |
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| ==Treatment== | | ==Treatment== |
| [[Croup medical therapy|Medical therapy]] | [[Croup surgery|Surgical options]] | [[Croup primary prevention|Primary prevention]] | [[Croup secondary prevention|Secondary prevention]] | [[Croup cost-effectiveness of therapy|Financial costs]] | [[Croup future or investigational therapies|Future therapies]] | | [[Croup medical therapy|Medical Therapy]] | [[Croup prevention|Prevention]] | [[Croup cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Croup future or investigational therapies|Future or Investigational Therapies]] |
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| ==Signs and symptoms==
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| Croup is characterized by a harsh 'barking' cough, inspiratory [[stridor]] (a high-pitched sound heard on inhalation), nausea/[[vomiting]], and [[fever]]. Hoarseness is usually present. More severe cases will have [[respiratory distress]].
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| The 'barking' cough (often described as a "seal like bark")<ref>
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| {{cite web
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| |url=http://www.lpch.org/diseasehealthinfo/healthlibrary/respire/croup.html
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| |date=2007-01-05
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| |title=Croup - Lucile Packard Children's Hospital}}</ref> of croup is diagnostic. [[Stridor]] will be provoked or worsened by agitation or crying. If [[stridor]] is also heard when the child is calm, critical narrowing of the airway may be imminent.
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| In diagnosing croup, it is important for the [[physician]] to consider and exclude other causes of shortness of breath and [[stridor]], such as [[foreign body]] aspiration and [[epiglottitis]].
| | ==Case Studies== |
| | | [[Croup case study one|Case #1]] |
| On a [[frontal]] [[X-ray]] of the [[C-spine]], the [[steeple sign]] suggests the diagnosis of croup.
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| ==Causes== | |
| Croup is most often caused by [[parainfluenza]] [[virus]], primarily types 1 and 3, but other viral and possibly [[bacterium|bacteria]]l infections can also cause it. It is most common in the fall and winter but can occur year-round, with a slight predilection for males.
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| The respiratory distress is caused by the inflammatory response to the infection, rather than by the infection itself. It usually occurs in young children as their airways are smaller and differently shaped than adults', making them more susceptible. There is some element of genetic predisposition as children in some families are more susceptible than others.
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| An entity known as '''spasmodic croup''' also occurs, distinct from the infectious variety, due to [[laryngospasm|laryngeal spasms]].
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| ==Treatment==
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| The treatment of croup depends on the severity of symptoms.
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| One of the simplest ways to treat croup is to inhale hot steam. This was the sole treatment for croup throughout the nineteenth and most of the twentieth century. [[Hospital]]s today use a "blowby" apparatus for this purpose. Simpler remedies include taking the child outside in moist night air, or alternatively exposing the child to steam from a hot bath or a humidifier. These techniques may help in some cases, but there is little hard evidence to support their efficacy.
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| Mild croup with no [[stridor]], or stridor only on agitation, and just a cough may simply be observed, or a dose of inhaled, oral, or injected steroids may be given. When steroids are given, [[dexamethasone]] is often used, due to its prolonged physiologic effects.
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| Moderate to severe croup may require [[nebulizer|nebulized]] [[adrenaline]] in addition to steroids. [[Oxygen]] may be needed if [[Hypoxia (medical)|hypoxia]] develops. Children with moderate or severe croup are typically hospitalized for observation, usually for less than a day. [[Intubation]] is rarely needed (less than 1% of hospitalized patients).
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| ==Prognosis==
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| Viral croup is a [[Self-limiting|self-limited]] disease, but can very rarely result in death from complete airway obstruction. Symptoms may last up to 7 days, but typically peak around the second day of illness. Rarely, croup can be complicated by (or confused with) an acute bacterial [[tracheitis]], which is more dangerous.
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| ==References==
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| <references/>
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| ==External links==
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| * [http://www.mayoclinic.com/health/croup/DS00312 MayoClinic]
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| * [http://www.askdrsears.com/html/8/t084200.asp Ask Dr. Sears]
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| * Four kinds of croup http://www.healthscout.com/ency/68/135/main.html
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| {{Respiratory pathology}} | | {{Respiratory pathology}} |
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| [[de:Pseudokrupp]]
| | {{WH}} |
| [[es:Laringotraqueobronquitis]]
| | {{WS}} |
| [[it:Croup]]
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| [[nl:Pseudokroep]]
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| [[ja:クループ]]
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| [[no:Falsk krupp]]
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| [[nn:Falsk krupp]]
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| [[ru:Круп]]
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| {{SIB}}
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| [[Category:Pediatrics]] | | [[Category:Pediatrics]] |
| [[Category:Infectious disease]]
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| [[Category:Pulmonology]] | | [[Category:Pulmonology]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
| [[Category:Disease]] | | [[Category:Disease]] |
| [[Category:Mature chapter]]
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