What Is Croup?
Croup (also called laryngotracheobronchitis) is a viral respiratory illness characterized by barking cough, high-pitched and noisy breathing (stridor), and hoarseness.
Can Adults Get Croup?
Children six months to three years of age are most commonly affected by croup. Adults may get croup and experience the same symptoms, but it is very rare.
What Is the Treatment for Croup?
Treatment to get rid of mild croup cough is aimed at relief of symptoms and home remedies are often sufficient. Home treatment for mild croup cough include:
- Adequate fluid intake
- Over-the-counter (OTC) fever reducers
A single dose of oral dexamethasone may be prescribed for mild croup.
Treatment for moderate to severe croup includes:
- Oral if tolerated, intravenous (IV) or intramuscular (IM) if oral intake is not tolerated
- Nebulized budesonide is an alternative
- Nebulized epinephrine
- Supplemental oxygen if needed
- Supportive care
- Humidified air or oxygen
- Fever reducers
- Adequate fluid intake
What Are Symptoms of Croup?
Early signs and symptoms of croup include:
- Runny nose
- Inflammation of the mucus membranes inside the nose (coryza)
After the initial symptoms, croup develops over 12 to 48 hours and symptoms may include:
- Barking cough
- High-pitched, noisy breathing (stridor)
- Mild sore throat
- Mild fast, shallow breathing
- Pneumonia (in severe cases)
The cough associated with croup usually goes away within three days, while other symptoms may continue for up to a week and then gradually resolve.
Is Croup Contagious?
Croup is spread easily through contact with an infected person's coughing, sneezing, and respiratory secretions (mucus and droplets from coughing or sneezing). Children with croup are considered contagious for three days after the illness begins or until the fever is gone.
Croup is usually caused by viruses. Secondary bacterial infection may occur.
Viruses that cause croup include:
- Parainfluenza viruses
- Most cases of croup occur in the fall (often in October) or early winter, which coincides with parainfluenza type 1 activity
- Human coronavirus NL63 (HCoV-NL63)
- This is not the same coronavirus as the one that causes COVID-19
- Respiratory syncytial viruses (RSV)
- Enteroviruses (especially Coxsackie types A9, B4, and B5, and echovirus types 4, 11, and 21)
- Herpes simplex viruses
- Influenza viruses (uncommon)
- Measles (in areas where measles remains prevalent)
Croup also may be caused by bacteria, including Mycoplasma pneumoniae.
Secondary bacterial infections of croup include:
- Staphylococcus aureus
- Streptococcus pneumoniae
- Streptococcus pyogenes
A risk factor for croup and recurrent croup is a family history of the illness.
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