Hopkins 24/7

Back to ABC News

This Thursday at 10/9c

This content requires javascript and flash player version 8.

Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

Close Article Browser

Croup

What is it?

Croup is a condition marked by obstruction of breathing due to inflammation and narrowing of the air passages. It develops from a respiratory infection, such as a cold or the flu, peaks in severity between three and five days, and resolves by the sixth day. Symptoms include noisy breathing, stridor (a high-pitched whistling sound when inhaling), and a tight, barking cough (like a seal). These may fluctuate from mild to severe, but are usually worse at night. Croup generally affects children up to the age of five. It is more common in boys than girls and is more likely to occur in the winter. Older children and adults are not at risk for croup because their airways are wider and thus resistant to collapse.

What Causes It?

  • Viral infections—including flu, measles, and colds—are the most common cause of croup.
  • Bacterial infections sometimes lead to croup.

Prevention

  • Wash hands frequently with warm water and soap to prevent spreading the infection to other children.

Diagnosis

  • Physical examination and patient history are needed.
  • A neck x-ray or laryngoscopy (using a lighted scope to view the inside of the throat) may be performed to locate specific sites of airway obstruction.

How to Treat It

  • Have the child inhale moist air from a bowl of steaming water, cool-mist humidifier, or hot shower, to help relieve congestion during an attack. Having the child breathe cool night air may also help open the airways.
  • Sitting up straight makes breathing easier. Infants may be placed in a child seat.
  • Acetaminophen may be administered to reduce fever. (Do not give aspirin to children.)
  • Be calm and reassure the child; anxiety and crying aggravate symptoms.
  • The use of corticosteroids (injected or taken orally) may improve stridor.
  • Antibiotics may be prescribed if there is thought to be an additional bacterial infection; they should be taken for the full term prescribed.
  • Hospitalization may be necessary for severe attacks. The child may be placed in a humidified oxygen tent and given the drug epinephrine, which helps to decrease the swelling of the airway.
  • In very serious cases, the doctor may insert a breathing tube down the child's throat through the mouth or through a small incision in the neck (tracheostomy). The tube can usually be removed within 24 hours.

When to Call a Doctor

  • Call a doctor if your child develops noisy, rapid breathing.
  • Be alert for signs of ear infections and pneumonia, potential complications of croup that may arise a few days after an attack subsides.
  • EMERGENCY Call an ambulance immediately if your child experiences serious breathing difficulty or develops other emergency symptoms of severe lung obstruction.