Interestingly enough, croup (aka laryngotracheobronchitis) is not actually a specific virus but rather a description of a disease state. It is marked by a harsh cough often sounding like a seal bark and can be caused by a variety of organisms, including parainfluenza, human metapneumovirus, adenovirus and even influenza. The reason for the croupy cough and sometimes associated stridor (high-pitch breathing sound upon inhalation) is the swelling that occurs around the larynx (vocal cords) and trachea (windpipe). Younger children are most susceptible to this illness, secondary to their small airways. And because the symptoms often worsen at night, this illness can be a very scary experience for both the child and the parents.

Most cases of croup usually are not serious and can be treated at home. Home measures include exposure to humidified air (whether it be from a humidifier or taking your child into a steam-filled bathroom) and even some cool night air (wrap your child up and walk outside for a few minutes) and, of course, drinking plenty of fluids. However, if symptoms do not respond to home measures, an immediate evaluation by a physician is warranted, as possible medications may be needed, including steroids and/or epinephrine (delivered in a mist-like form).

And other reasons to immediately see us in the office or, if at night, the local ED or urgent care include:

  • Impressive stridor (the high-pitched inspiratory breathing sounds)
  • Drooling or any difficulty swallowing
  • Any extreme irritability or agitation
  • Difficulty breathing
  • Around the mouth, nose bluish hue (perioral cyanosis)
  • A fever approaching 104°F