Croup

Croup
ICD-10	J05.0
ICD-9	464.4
DiseasesDB	13233
MedlinePlus	000959

WikiDoc Resources for Croup
Articles
Most recent articles on Croup Most cited articles on Croup Review articles on Croup Articles on Croup in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Croup Images of Croup Photos of Croup Podcasts & MP3s on Croup Videos on Croup
Evidence Based Medicine
Cochrane Collaboration on Croup Bandolier on Croup TRIP on Croup
Clinical Trials
Ongoing Trials on Croup at Clinical Trials.gov Trial results on Croup Clinical Trials on Croup at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Croup NICE Guidance on Croup NHS PRODIGY Guidance FDA on Croup CDC on Croup
Books
Books on Croup
News
Croup in the news Be alerted to news on Croup News trends on Croup
Commentary
Blogs on Croup
Definitions
Definitions of Croup
Patient Resources / Community
Patient resources on Croup Discussion groups on Croup Patient Handouts on Croup Directions to Hospitals Treating Croup Risk calculators and risk factors for Croup
Healthcare Provider Resources
Symptoms of Croup Causes & Risk Factors for Croup Diagnostic studies for Croup Treatment of Croup
Continuing Medical Education (CME)
CME Programs on Croup
International
Croup en Espanol Croup en Francais
Business
Croup in the Marketplace Patents on Croup
Experimental / Informatics
List of terms related to Croup

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Croup (sometimes referred to as croup syndrome or laryngotracheobronchitis) is a respiratory disease which afflicts infants and young children, typically aged between 3 months and 3 years. The respiratory symptoms are caused by inflammation of the larynx and upper airway, with resultant narrowing of the airway.

Signs and symptoms

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.

The 'barking' cough (often described as a "seal like bark") 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.

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.

On a frontal X-ray of the C-spine, the steeple sign suggests the diagnosis of croup.

Causes

Croup is most often caused by parainfluenza virus, primarily types 1 and 3, but other viral and possibly bacterial 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.

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.

An entity known as spasmodic croup also occurs, distinct from the infectious variety, due to laryngeal spasms.

Treatment

The treatment of croup depends on the severity of symptoms.

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. Hospitals 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.

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.

Moderate to severe croup may require nebulized adrenaline in addition to steroids. Oxygen may be needed if 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).

Prognosis

Viral croup is a 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.

External links

• MayoClinic
• Ask Dr. Sears
• Four kinds of croup http://www.healthscout.com/ency/68/135/main.html