Croup is a very common respiratory or lungs related problem in young children. This is a recurring health disorder that occurs around the fall or winter and brings with it a harsh cough. The condition causes narrowing of the windpipe making breathing difficult. Along with the cough, there is a change in voice. The hoarse voice is accompanied with a crowning noise while breathing. The symptoms tend to increase during the night.
HOW IS CROUP DIAGNOSED?
Croup is a clinical diagnosis. The first step is to exclude other obstructive conditions of the upper airway, especially epiglottitis, an airway foreign body, subglottic stenosis, angioedema, retropharyngeal abscess, and bacterial tracheitis. A frontal X-ray of the neck is not routinely performed, but if it is done, it may show a characteristic narrowing of the trachea, called the steeple sign, because of the subglottic stenosis, which is similar to a steeple in shape. The steeple sign is suggestive of the diagnosis but is absent in half of the cases. Other investigations (such as blood tests and viral culture) are discouraged, as they may cause unnecessary agitation and thus worsen the stress on the compromised airway. While viral cultures, obtained via nasopharyngeal aspiration, can be used to confirm the exact cause, these are usually restricted to research settings. Bacterial infection should be considered if a person does not improve with standard treatment, at which point further investigations may be indicated.
HOW IS CROUP TREATED?
Children with croup are generally kept as calm as possible. Steroids are given routinely, with epinephrine used in severe cases. Children with oxygen saturations under 92% should receive oxygen, and those with severe croup may be hospitalized for observation. If oxygen is needed, ""blow-by"" administration (holding an oxygen source near the child's face) is recommended, as it causes less agitation than the use of a mask. With treatment, less than 0.2% of people require endotracheal intubation
DID YOU KNOW?
Severe cases may require hospital stay and more focussed medical intervention.