Croup is a viral infection of the upper part of the airway and voice box. It is caused by the same viruses that can cause colds (see the section on colds on this website). It is most common in younger children and is associated with low-grade fever, hoarseness and a loud barking cough. Although croup is usually not serious, occasionally a child with croup can have an attack of breathing difficulty which usually occurs at night. During these attacks, the child will be noticed to have difficulty drawing in his breath. You may even notice extra breathing movements called retractions in which the skin above the collar bone, over the ribs, and over the stomach depress in with respirations. This airway obstruction is due to swelling which occurs in the upper airway around the larynx (voice-box). If breathing difficulty occurs and this is accompanied by retractions please see the section which follows on the treatment of croup.
Treatment of Croup:
- Give the child plenty of clear liquids and use a vaporizer to keep the secretions moist (we recommend cool mist).
- If you desire you may treat the fever with acetaminophen (Tylenol, see Dosing Guide for dose) for comfort’s sake. Please see the section on fever for a description of the benefits of fever in fighting off a viral infection.
- During an attack of breathing difficulty, place the child in the bathroom, turn the shower on hot and fill the room with steam. Fifteen to 20 minutes in this environment will often relieve the attack. If this does not work, wrap the child up warmly and take her out into the cool night air for a few minutes. Also, hold your child upright. This moves the swollen voicebox above the heart minimizing swelling. If these measures fail to help and she continues to have breathing difficulty, she will need to be taken to the office or to the emergency room.
- We generally treat the breathing difficulty of croup with an oral cortisone type medication or a cortisone type medication given by injection.
- If your child develops an inability to swallow manifested by constant drooling and has the above symptoms of barky cough, fever (usually high), hoarse voice and breathing difficulty, she may have a serious bacterial infection of the throat called epiglottitis. This requires an immediate trip to the emergency room.
Do not start any leftover antibiotic prescriptions, as these drugs do not cure the common cold and can cause more harm than good (see section on antibiotics on our website).