When Croup Symptoms Don’t Respond To Treatment

13 days ago my son was diagnosed with croup and asthma. He was started on nebulizer treatments 4 times a day, which we have been doing for 13 days now. He has also been on prelone for 5 days, and amoxil for 6 days. He had a chest x-ray because the pediatrician said croup is only supposed to last for 10 days. The x-ray showed something behind the left ventricle of the heart, but they couldn’t be sure if it was pneumonia and want to do another x-ray. He is no better on day 13 than he was on day one. He also has yellow/green junk from his nose.

When Croup Symptoms Don't Respond

Dr. Greene’s Answer:

With croup symptoms that show no sign of improvement after 5 days of prelone, it’s time to think of other possible causes — especially with an unidentified something on the chest x-ray.

An inhaled foreign body can cause croup, and would not respond to treatment. Pneumonia could be the cause. Mycoplasma is also possible. Mycoplasma wouldn’t respond to amoxicillin; it would need a different antibiotic.

Croup is typically caused by parainfluenza viruses and is over quickly, but it can also be caused by longer-lasting viruses such as RSV (respiratory syncytial virus), especially in kids with asthma.

In any event, unless the x-ray was read by a pediatric radiologist, I would be in favor of getting a second opinion for your 8-month-old son. The closest children’s hospital would be a good place, and could also direct you to the best place close to you. Most children’s hospitals have a parents’ advice line to get you steered in the right direction.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

Sign-up for DrGreene's Newsletter

About once a month we send updates with most popular content, childrens' health alerts and other information about raising healthy children. We will not share your email address and never spam.

Enter your message.

Your email address will not be published. Required fields are marked *