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==Pathophysiology==
==Pathophysiology==
The viral infection that causes croup leads to swelling of the [[larynx]], [[Vertebrate trachea|trachea]], and large [[bronchi]] due to infiltration of [[white blood cells]] (especially [[histiocytes]], [[lymphocytes]], [[plasma cells]], and [[neutrophils]]). Swelling produces airway obstruction which, when significant, leads to dramatically increased work of breathing and the characteristic turbulent, noisy airflow known as [[stridor]].
Development of croup results from infiltration of white blood cells through the human parainfluenza virus (HPIV). HPIV expels its nucleocapsid into the recipient cell cytoplasm. The viral transcription then occurs through the HPIV RNA-dependent RNA polymerase. The viral [Messenger RNA|mRNAs] are translated into viral proteins, leading to the replication of the genome into the negative-sense RNA strand, which is then encapsidated by the nucleoprotein and used for further transcription and replication. The inflammation response to HPIV occurs from the up-regulation of cytokines and the released Immunoglobulin E inhibiting histamine. The resultant swelling of the larynx, trachea, and large bronchi obstructs the airways obstruction which leads croup.


==Causes==
==Causes==

Revision as of 17:41, 23 February 2016

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

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Overview

Croup 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.

Historical Perspective

Diptheritic croup reports date back to the Homer-era of Ancient Greece, speculating to have emerged in the 12th century B.C.E. The Viral-based croup was discovered in 1826 by French medical doctor Pierre Bretonneau. Initial therapies included cold water mist to soothe pain as well as tracheotomy for patients with severe cases requiring hospitalization. In the 1970s, nebulized Epinephrine emerged as a therapy. Glucocorticoid therapies emerged in the late 1980s' and 1990's. Preventative therapy emerged with successful Immunization of individuals against diptheritic croup with the development of influenza and diptheria vaccines.

Pathophysiology

Development of croup results from infiltration of white blood cells through the human parainfluenza virus (HPIV). HPIV expels its nucleocapsid into the recipient cell cytoplasm. The viral transcription then occurs through the HPIV RNA-dependent RNA polymerase. The viral [Messenger RNA|mRNAs] are translated into viral proteins, leading to the replication of the genome into the negative-sense RNA strand, which is then encapsidated by the nucleoprotein and used for further transcription and replication. The inflammation response to HPIV occurs from the up-regulation of cytokines and the released Immunoglobulin E inhibiting histamine. The resultant swelling of the larynx, trachea, and large bronchi obstructs the airways obstruction which leads 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.

Epidemiology and Demographics

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.

Natural History, Complications and Prognosis

Viral croup is a self-limited disease, symptoms lasting up to 7 days. It can very rarely result in death from complete airway obstruction.

Treatment

Primary Prevention

Wash your hands frequently and avoid close contact with those who have a respiratory infection.

The diphtheria, haemophilus influenzae (Hib), and measles vaccines protect children from some of the most dangerous forms of croup.

References


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