Croup is an infection that affects the voice box (larynx) and the airway to the lungs (trachea). The scientific name for croup is laryngotracheitis. Croup is characterised by the sudden onset of a ‘seal-like’, barking cough that is usually accompanied by a rasping sound when breathing in, known as inspiratory stridor. Other common characteristics of the condition include a hoarse or croaky voice and respiratory distress due to obstruction of the upper airways.
Who is affected by croup?
Croup usually affects young children between six months and three years old. However, children who are over six years old may sometimes get croup. It is also possible for children under six months of age to develop croup, although this is rare. Croup tends to affect boys more than girls. During childhood, those affected by croup may get the condition two or more times.
Symptoms of croup
Croup is much more likely to occur during the winter months. The initial symptoms of croup are very similar to those of a cold. If your child has croup they may have a bark-like cough, a runny nose, and a fever – a temperature of 38C (100.4F) or above.
Bark-like cough
Between 1-4 days after becoming infected, your child will develop a cough that sounds like a ‘bark’. This is the characteristic sign of croup. Most children with croup will develop a hoarse, or croaky voice. When breathing in, it is also likely that your child will make a rasping sound. This is known as inspiratory stridor. Inspiratory stridor will often be most noticeable when a child cries, or coughs but, in more severe cases of croup, it can also happen when the child is resting, or sleeping. The bark-like cough and inspiratory stridor tend to be worse during the night.
Croup is usually at its worst for 48 hours after the cough has started. After this time, you should start to see improvements. It is very common for a more ‘regular’ cough to remain for a few days after the condition has improved.
When to seek medical advice
If your child’s croup symptoms get worse, you should seek immediate medical advice. You should ask for an emergency medical assistance if your child’s condition worsens in any of the ways listed below.
- Your child is struggling to breathe.
- Your child unusually sleepy.
- Your child becomes cyanosed (they have a blue tinge to their lips, or face).
In particular, you should seek urgent medical advice in either of the circumstances outlined below.
- The obstruction of your child’s airways worsens. For example, they develop inspiratory stridor intermittently (every so often) while at rest, or they are having to use increasing effort to breathe. If your child is experiencing breathing difficulties, they may need to be admitted to hospital for observation.
- Your child becomes pale, has a high fever, and a rapid heartbeat. This may indicate that they have an underlying condition, such as epiglottitis (inflammation of the epiglottis – the flap of cartilage that closes off the entry to the voice box when you swallow), or tracheitis (inflammation of the windpipe).
Causes of croup
Croup is often caused by a viral infection that is passed on from one child to another. It is possible for a child to get croup several times before their airway is large enough to be unaffected by the condition.
Parainfluenza virus
The most common virus that causes croup is the parainfluenza virus. However, the condition can also be caused by both the flu virus and the measles virus.
Bacterial infections
In very rare cases, bacterial infections can cause croup.
Diagnosing croup
Your doctor will diagnose croup based on the sound of your child’s cough, and the symptoms that they are experiencing around the same time as the cough, such as a hoarse, or croaky voice, and difficulty breathing.
Your doctor may also take your child’s temperature to see if they have a fever, and will ask whether your child has recently had a cold, or a viral infection.
Ruling out underlying conditions
Your doctor will want to rule-out any other conditions that may cause similar symptoms to croup, such as epiglottitis (inflammation of the epiglottis) and tracheitis (inflammation of the windpipe).
Your doctor will decide if hospital admission is needed, or whether your child’s croup is safe to treat at home.
Further investigation
If your child is admitted to hospital, or if treatment is unsuccessful, they may need to have further investigations in order to examine their neck and chest area for a possible obstruction.
You should not try to check your child’s throat because this can trigger a spasm of the airway. A spasm can cause even more swelling and obstruction to the airways, making breathing even more difficult.
Related Articles:
- Treating croup infection
- Inflamed airways — Bronchitis
- Respiratory tract infection — Bronchiolitis
- Chest infection in adults
- Chronic obstructive pulmonary disease
- Asbestosis – Chronic lung disease
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