Signs of Croup (Upper airway inflammation)

Croup (Upper Airway Inflammation)

Description

A viral infection that causes swelling and irritation of the area around the vocal cords leading to the characteristic seal barking cough and noisy breathing (strider). Since it is a virus antibiotics are not effective. Steroids are sometimes given to reduce the swelling and shorten the course of the illness. Most cases resolve on their own but some require medical treatment and rarely croup can be life threatening.

Symptoms

Characteristic deep barking cough (seal barking cough), noisy upper airway breathing (strider) that becomes worse with crying or agitation, rapid breathing, bluish discoloration of skin (cyanosis), fever. The symptoms are usually worse at night and the first few nights of the disorder can be the worst.

Tests

A history and physical exam will be performed. Generally the diagnosis is made without tests. At times a x-ray is done, and at times the doctor will look at the epiglottis to rule out epiglotittis (a serious bacterial infection of the epiglottis).

Standard Workup

X-Ray

Treatment

Most cases can be safely managed at home with a cool moist vaporizer and treatment of an associated fever with acetaminophen/Tylenol. Relief of symptoms can be achieved by taking the child into the cool air, and/or into a steam filled bathroom. More severe cases require medical treatment with: epinephrine breathing treatments, oral or intramuscular steroids, and possibly admission to the hospital. Rarely the disease is life threatening and can require insertion of a breathing tube.