Significance

• Although croup is usually a mild illness, it can lead to serious conditions that require hospitalization, such as extreme difficulty breathing, dehydration and stopped or slowed breathing. A severe upper airway infection, known as bacterial tracheitis, can also occur. An infected epiglottis will lead to swelling, or epiglottitis, and require immediate medical attention to prevent fatality. Other complications that could develop from croup include pneumonia and ear infections, although these rarely occur. Children under three years of age face the greatest risk of severe symptoms due to their smaller airways.
  
  

Causes

• Croup usually develops due to a viral infection. The parainfluenza virus causes most cases, although exposure to other viruses, such as respiratory syncytial virus, adenovirus, measles or influenza can also lead to croup. A virus can enter your child's body if he breathes in droplets when an infected person sneezes or coughs. He could also be exposed to viruses that linger on toys or other objects that he frequently touches. These viruses can pass into his body when he touches his eyes, mouth or nose after handling contaminated items. Less common causes of croup include bacteria, acid reflux, allergies and inhaled irritants or objects.
  
  

Symptoms

• Your child might experience a mild cough that lasts for several days before the barking cough associated with croup begins. The barking cough usually becomes worse at night and lasts for up to six nights. The most severe coughing typically occurs during the first and second nights. The cough will usually become more frequent, which could make breathing more difficult. Seek emergency medical care if your child's coughing is due to an inhaled object or insect sting, if she has trouble swallowing, if she's drooling or if her skin turns a bluish color, which indicates that she can't get enough oxygen. Call your pediatrician right away if your child's breathing is noisy or if she becomes extremely irritable.
  
  

Home Care

• Mild cases of croup can usually be treated at home. Set up a cool mist vaporizer or humidifier in your child's room to keep the air moist. Let him rest as often as possible and give him plenty of fluids. Hold him on your lap or put him in a car seat to keep him upright, which will help him breathe. Take your child out for some fresh air in cool weather. Give your child acetaminophen if he has a fever. If you have a baby, make sure you only give him an infant pain reliever. Prescription steroid medications or medicated aerosol treatments can also provide relief. Your child should show improvement within one week if he has viral croup.
  
  

Medical Treatment

• Severe cases of croup require medication and hospitalization. Treatment involves the use of aerosolized racemic epinephrine or injected, oral or inhaled forms of corticosteroids to relieve swelling in the upper airway. A tent might be placed over your child's hospital crib to provide her with oxygen. If she has bacterial croup, she'll be given antibiotics. An obstructed airway requires immediate treatment to prevent respiratory distress or respiratory arrest. Treatment involves intubation, or running a tube from the mouth or nose to the main airway in the lungs. Intravenous fluids will help treat dehydration.
  
  

Prevention

• Washing your hands frequently can keep germs from spreading. Avoid bringing your child into contact with people who are ill. Make sure your child receives all scheduled immunizations. Vaccines for measles, diptheria and Haemophilus influenzae type b, or Hib, can provide protection against upper airway infections that could result in serious cases of croup.