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How Do You Treat Croup at Home?

Reviewed on 10/22/2020

What Is Croup?

Croup is a viral respiratory infection common in children up to three years old. Rest, fluids and humidifiers are often the best treatment for croup.
Croup is a viral respiratory infection common in children up to three years old. Rest, fluids and humidifiers are often the best treatment for croup.

Croup (also called laryngotracheobronchitis) is a viral respiratory illness characterized by high-pitched, noisy breathing (stridor), barking cough, and hoarseness.

Croup commonly affects children six months to three years of age.

What Are Symptoms of Croup?

Early symptoms of croup include: 

  • Runny nose
  • Congestion
  • Inflammation of the mucus membranes inside the nose (coryza)

After the initial symptoms, croup progresses over 12 to 48 hours and symptoms include:

The cough associated with croup typically goes away within three days. Other symptoms may persist for up to a week and then gradually resolve.

What Causes Croup?

Croup is usually caused by viruses. Secondary bacterial infection may occur.

Viruses that cause croup include: 

  • Parainfluenza viruses
  • Respiratory syncytial viruses (RSV)
  • Adenoviruses 
  • Human coronavirus NL63 (HCoV-NL63)
  • Measles (in areas where measles remains prevalent)
  • Influenza viruses (uncommon)
  • Rhinoviruses
  • Enteroviruses (especially Coxsackie types A9, B4, and B5, and echovirus types 4, 11, and 21)
  • Herpes simplex viruses 
  • Metapneumoviruses 

Croup also may be caused by bacteria, including Mycoplasma pneumoniae.

Secondary bacterial infections of croup include: 

A risk factor for croup and recurrent croup is a family history of the illness.

Most cases of croup occur in the fall (often in October) or early winter, which coincides with parainfluenza type 1 activity.  

How Is Croup Diagnosed?

The diagnosis of croup is based on the presence of high-pitched, noisy breathing (stridor) and barking cough, especially during a period when one of the causative viruses is active in the community. 

Tests may be used to rule out other conditions, such as:

  • Chest X-ray
  • Blood tests
    • White blood cell (WBC)
    • Serum bicarbonate 
    • Blood urea nitrogen (BUN)
  • Viral culture and/or rapid diagnostic tests that detect viral antigens 

What Is the Treatment for Croup?

Treatment for mild croup is aimed at relief of symptoms and can be treated at home. Home treatment for mild croup includes: 

  • Humidifier/mist
  • Fever reducers (antipyretics)
  • Adequate fluid intake

Medical treatment for mild croup may include: 

Treatment for moderate to severe croup includes: 

  • Nebulized epinephrine 
  • Dexamethasone: oral if tolerated, intravenous (IV) if IV access has been established, or intramuscular (IM) if oral intake is not tolerated and IV access has not been established
  • Nebulized budesonide is an alternative 
  • Supplemental oxygen if needed
  • Supportive care
  • Humidified air or oxygen
  • Fever reducers (antipyretics)
  • Adequate fluid intake

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Reviewed on 10/22/2020
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