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US Pharm. 2019;44(5):13-14 Usually Caused by Cold or Flu VirusCroup, a type of respiratory infection that affects the upper airways, is almost always caused by a cold or flu virus. Rarely, croup can be caused by a bacterial
upper-respiratory infection, inhaled allergens, or other irritants. Croup is marked by a swelling of the tissue around the voice box and windpipe that results in a tight, barking cough and hoarseness. The condition usually occurs in infants or children under the age of 5 years, although some older children and teens may suffer from it. Because croup starts with a cold or flu virus, the condition is more common during the winter, when these viral infections are prevalent. Marked by a Loud, Barking CoughCroup usually begins a few days after the symptoms of a mild cold and usually is worse during the nighttime hours. Often, the tight, barking cough and difficulty breathing will suddenly awaken the child. The symptoms of croup occur because the swelling of the tissue around the voice box (larynx), windpipe (trachea), and bronchial tubes narrow the airway passages, making it difficult to inhale and exhale. If the child’s airway is narrowed sufficiently, a harsh, rasping noise occurs when the child breathes in. This symptom is called stridor. Young children are particularly susceptible because their young airways are already small. Because of the symptoms, croup can be a frightening condition for the parent as well as for the child, although it usually is not a serious illness. Croup is diagnosed by performing a physical examination that includes listening to the child’s breathing and cough, examining the throat, and sometimes chest x-rays to rule out other diseases. At-Home TreatmentThe treatment of croup depends on the severity of symptoms. Most children can be effectively treated at home. At-home treatment of croup includes increased intake of fluids and plenty of rest during the day, with acetaminophen to treat fever, if present. Cough medicine should not be used unless directed by a physician. At bedtime, the use of a cold, moist air vaporizer in the child’s room is often recommended. If the cough becomes severe during the night, many doctors recommend keeping the child in an upright position while breathing in warm, humidified air from a steamy bathroom after running a hot shower. Since cool air may also help troublesome croup symptoms, caregivers are instructed to try opening a window to let the child breathe the cooler air. Remaining calm and comforting the child will help lower his or her anxiety level and minimize crying, which can make the symptoms worse. If these measures do not ease the symptoms or if the child is extremely agitated, shows bluish skin around the lips, or has difficulty swallowing or moving air, medical treatment should be sought immediately—don’t wait until morning. Treating Serious CasesThe treatment of a more severe case of croup, especially if the child is having difficulty moving air, requires a physician’s care. In many cases, a short course of oral corticosteroids will relieve the swelling that causes the symptoms, helping lessen the cough and making it easier for the child to sleep. In serious cases of croup, drugs such as corticosteroids or epinephrine can be used along with humidified air to ease the cough and breathing difficulties associated with severe airway swelling. In some children, a few days of oral corticosteroids will help shrink the swelling and clear symptoms more quickly. Serious bacterial causes of croup include epiglottitis and bacterial tracheitis. Epiglottitis is a life-threatening inflammation of the epiglottis (a flap of cartilage that covers the airway during swallowing) in which the resulting swelling can block the airway. Bacterial tracheitis is a bacterial infection of the upper airway. Both of these conditions require diagnosis by a doctor and antibiotic therapy. If you have questions about croup or managing nighttime symptoms, talk to your local pharmacist or another healthcare practitioner. To comment on this article, contact . Viral croup and bronchiolitis are common respiratory infections in young children. Unlike the usual coughs and colds, the inflammation in the airway associated with croup and bronchiolitis can often be significant, causing noisy and difficulty breathing. Croup
affects the upper airway, and bronchiolitis the lower airway/bronchioles. Croup is a viral respiratory infection of the upper airway, which causes swelling of the voice box (larynx) and windpipe (trachea). The swelling causes a narrowing of the airway, which causes noisy breathing and a hoarse voice. The cough is described as a “barking” cough. It can cause difficulty breathing if left untreated. The onset of croup generally starts like any other respiratory infection with mild symptoms of runny nose, congestion, and fever. Typically, croup is a mild illness, and most children with croup are better in a few days. However, croup can get worse quickly, especially in the younger child, as their airways are smaller. Children often suffer from worsening symptoms in the evening, and a croupy cough develops. The hallmark of croup is a hoarse and distinct cough that is harsh, high-pitched like a seal barking. The high-pitched or squeaking noise when breathing in is referred to as stridor. The child might also have an increase in effort when breathing in, and you might see the skin between the ribs pull in when breathing. Symptoms tend to wax and wane, improving somewhat by the morning and worsening in the evening. What age do children typically get croup?Croup tends to occur in children between 3 months to five years old, but it can occur at any age. In some children, croup tends to reoccur. What is the difference between croup and bronchiolitis?In contrast to croup, bronchiolitis is characterized by inflammation of the lower airway/bronchioles. The narrowing or congestion of the bronchioles produces wheezing, a high-pitched whistling sound when breathing out and labored breathing. Bronchiolitis affects young children under the age of two, most commonly in babies three to six months old. However, some babies are at risk for severe bronchiolitis, including those born prematurely with a chronic heart or lung disease. How long does croup or bronchiolitis last?Croup typically lasts four to five days but may last up to a week. Bronchiolitis usually lasts about two weeks, though a persistent cough can last several weeks in severe cases. Typically, day 3-4 of the illness is the worst. Therefore, we would expect a child to be turning a corner on day four and generally improving. How do children get croup or bronchiolitis?Croup and bronchiolitis are contagious like other respiratory infections, spreading through direct contact with respiratory secretions. Thus, basic hygiene is essential in helping limit the spread of these illnesses. What is the treatment for both?Both croup and bronchiolitis are often mild illnesses and can be managed at home.
For croup, some children may benefit from steroids to promptly relieve mild symptoms, while additional aerosolized treatment is necessary for the more moderate and severe illness. Sometimes a child with either croup or bronchiolitis may need a short hospital stay for observation, oxygen or hydration support. When to call your doctor or get immediate medical careDue to airway inflammation, both croup and bronchiolitis can make children feel miserable and quite ill. Therefore, it is important to keep a close eye and seek help urgently if your child develops noisy or labored/difficulty breathing appears tire and lethargy or is not drinking well and appears dehydrated.
What disease is characterized by a barking cough in children?Laryngotracheitis (croup) — Croup is a respiratory illness characterized by inspiratory stridor, barking cough, and hoarseness.
What is an acute respiratory infection in children and infants?Acute respiratory infections (ARIs) are classified as upper respiratory tract infections (URIs) or lower respiratory tract infections (LRIs). The upper respiratory tract consists of the airways from the nostrils to the vocal cords in the larynx, including the paranasal sinuses and the middle ear.
What is a barking cough?Croup is a common childhood illness that causes swelling in the upper airway. This can cause a change in voice and characteristic “croupy” cough that sounds like a seal or bark. There are a number of viruses that have been found to cause croup, the most common being parainfluenza virus.
What is the other name for croup?Croup is a common, primarily pediatric viral respiratory tract illness. As its alternative names, acute laryngotracheitis and acute laryngotracheobronchitis, indicate, croup generally affects the larynx and trachea, although this illness may also extend to the bronchi.
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What is an acute respiratory infection in children and infants characterized by a barking cough?
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