Child Coughs Loudly? Beware of Croup
Croup (Acute laryngotracheobronchitis) is an acute upper respiratory infection, common in young children. It’s usually caused by a virus, leading to inflammation and swelling from the larynx to the small bronchi. This results in a barking cough, abnormal breathing sounds, and even breathing difficulties.
Causes of Croup
Viral Infection
Accounts for 75–80% of cases. Common viruses include Parainfluenza, Influenza, RSV, Adenovirus, Coronavirus, and Metapneumovirus.
Bacterial Infection
Less common but more severe than viral causes.
Non-infectious Causes
Includes allergies or irritation from chemicals.
What Are the Symptoms of Croup?
Is your child showing signs of croup? Look for the following symptoms:
- Barking cough, especially at night
- Stridor (noisy breathing when inhaling)
- Hoarseness
- Cold-like symptoms 1–3 days prior: fever, runny nose, nasal congestion, sore throat
- Severe cases may include difficulty breathing, chest retraction, bluish hands/feet, and lethargy
How Is Croup Diagnosed?
Clinical History and Physical Exam
Key signs include barking cough and stridor. The throat may show red, swollen epiglottis.
Additional Tests
- Chest/neck X-ray may show the “steeple sign”—narrowing of the upper airway
- Oxygen saturation to assess severity
- Nasopharyngeal swab to detect viral causes such as influenza
How Is Croup Treated?
Supportive Care
- Elevate the child’s head while resting
- Use a humidifier or add moisture to the air
- Offer warm fluids and adequate hydration
- Keep the child calm and rested
- Use fever reducers if needed
- Oxygen therapy or intubation in severe respiratory distress
Medications
- Steroids (oral, inhaled, or injectable) to reduce airway inflammation—first-line treatment
- Nebulized epinephrine for temporary relief in severe cases
Most children recover within 3–7 days. However, the cough may persist for 1–2 weeks.
Possible complications include airway obstruction, secondary bacterial infections, dehydration, and electrolyte imbalance. Infants or immunocompromised children may develop more severe symptoms.
How to Prevent Croup
- Practice proper hand hygiene
- Influenza vaccination helps reduce severity
- Avoid close contact with infected individuals
