Croup
is an infection in childhood caused usually by a virus,
that results in a peculiar and irritating cough that is
often described as "barking" or "seal-like". Most children
experience this in the winter and usually it begins in
the night time with cold symptoms and fever often alongside.
Most children can be made comfortable by sitting upright
and opening the window but some children need to be taken
into the bathroom with the shower running and steam in
the air to moisten the airways. If 5-10 minutes in the
"steam" doesn't break the coughing spasm switch immediately
to cooler air by opening the window or going outside and
if it is hot out try opening the freezer door and breathing
nearby. The most unhelpful thing some parents do is to
get the child upset or excited by turning on bright lights
or trying to take a temperature and this can cause the
airway to get inflamed and make the croup worse. Croup
causes the airway to swell and in the most extreme cases,
rare though it is, a child may need emergency care in
order to allow sufficient airflow to get into the lungs.
Room temperature liquids only if your child is thirsty
and ibuprofen if you fell a fever and your child likes
to take medicine (don't fight over it since cooling down
is not vital at this time, staying calm and preventing
your child from crying is).
On
rare occasions a child may develop recurrent croup syndrome
which looks like a mild croup case with every cold for
a period of time after the first infection. It isn't clear
why this happens to some children but it isn't usually
dangerous at all. Don't hesitate to call your pediatrician
if your child awakens with a barking cough and isn't comfortable
after you've done the "steam" thing or she seems to be
struggling for breath. Call an ambulance if she can't
catch her breath and of course try to remain calm. Over
98% of croup cases do not even need a doctor's attention
so don't panic the first time you hear the "bark" - it
is a common childhood illness.
Definition
Croup,
also known as layngotrachaelbrochitis, is a contagious inflammatory
respiratory condition caused usually by a virus and resulting
in a severe and unusual sounding bark-like cough and difficulty
breathing. It generally occurs most commonly in young children
and while occurring year round, is more prevalent in late
fall and winter.
Usual
course
Croup often begins in the night with the wakening of a child
with a harsh and ominous sounding cough and difficulty taking
in breaths. The child is most comfortable in the upright
position and benefits from calm, reassurance and introduction
of moist air, preferably in a steamed up bathroom, dimly
lit for the sake of decreasing agitation. Crying and stress
increases the distress of the child as the airway may swell
and become even more narrowed. Often there is associated
fever and cold symptoms. Usually the distress responds well
to steaming and fluids and relief is followed by a return
to sleep only to be reawakened several more times in the
night. Generally this condition is much better by morning,
with only the symptoms of a runny nose and mild fever left.
The condition repeats itself in most cases each night for
a few nights (2-4) and then peters out over a week's time.
How
it is spread
Like all infectious conditions croup is spread by contact
with another person carrying the virus. The virus exists
in the respiratory particles spread by coughing, sneezing
and talking.
Similar
illnesses
Sometimes
croup can be confused with asthma in a child with a first
episode and although both require immediate attention, steam
may not help the asthmatic child and can make him more agitated
and uncomfortable. Since asthma is not a contagious condition
there is no fever associated with it and the absence of
a bark-like cough should alert you to this diagnosis which
requires emergency treatment. Another infectious condition
to be aware of is epiglottitis which is sudden in onset,
severe and does not respond to steam and fluids. The child
will have a very high fever and a very toxic appearance
and must be treated with emergency means right away.
When to call the doctor
If your child does not improve after 15 minutes of exposure
to moist air, warm or cold, and there is no decrease in
the comfort of breathing you must seek immediate emergency
care. In addition, if your child improves but continues
with the characteristic bark-like cough in the morning,
it is wise to consult your doctor since it is possible your
child's case requires intervention with medication such
as steroids to prevent an even worse episode the next night.
If your child is listless or unusually pale, even if seeming
to breathe comfortably, let the doctor have a look.
