Related concepts:

Laryngotracheobronchitis, Infectious croup, Spasmodic croup.

Introduction to croup:

Picture this scene: A couple is spending a quiet evening at home with their one-year-old daughter, who has had a bit of a cold. At about 8 o'clock she begins coughing -- an unusually loud, resonant cough. Over the next few hours, the sporadic cough becomes increasingly frequent. She gets a fever.

At 11 o'clock (when all the After Hours Clinics have closed, and her doctor is in bed), her breathing becomes noisy and labored. Each breath now makes a worrisome crowing noise unlike anything the parents have ever heard. Concerned, they bundle her up and take her to the local emergency room.

As they are pulling into the ER driveway, they notice that the child seems much, much better. After some heated debate (during which the little girl falls asleep peacefully), they decide to head home without being seen. An hour later, at home, the little girl is woken up by the loud cough, and her breathing is even more difficult...

What is croup?

Croup, bronchiolitis, bronchitis, and pneumonia are all words that denote the location in the body of a problem. Bronchiolitis refers to inflammation in the bronchioles, the smaller airways that branch off from the main bronchi or breathing tubes. Bronchitis is inflammation in these larger, main breathing tubes. Pneumonia refers to inflammation of the lungs themselves.

The word croup comes from an old Germanic word for the voice box. Today, croup, or laryngotracheobronchitis, refers to swelling centered at the larynx or vocal cords. Infection, allergy, or an inhaled foreign body can cause croup. GE reflux can trigger croup.

Croup is usually (75 percent of the time) caused by parainfluenza viruses, but RSV, measles, adenovirus, and influenza can all cause croup.

Before the era of immunizations and antibiotics, croup was a dreaded and deadly disease, usually caused by the diphtheria bacteria. Today, most cases of croup are mild. Nevertheless, it can still be a dangerous disease.

Who gets croup?

Croup tends to appear in children between 3 months and five years old, but it can happen at any age. Some children are prone to croup and may get it several times.

In the Northern hemisphere, it is most common between October and March, but can occur at any time of the year.

What are the symptoms of croup?

Croup is characterized by a brassy cough that sounds rather like a seal barking. Most children have what appears to be a mild cold for several days before one evening when the barking cough becomes evident. As the cough gets more frequent, the child may have stridor (a harsh, crowing noise made during inspiration).

If the child has stridor constantly, she should be seen immediately. If you suspect a foreign body or an insect sting as the cause of croup, she should be seen immediately.