Sunday, May 6, 2012


My neighbor’s son was diagnosed with croup, what is this and can my children catch it?

Affecting tens of thousands if not more children during the first 6 years of their life laryngotracheitis, better known as croup, is one of the most common pediatric respiratory diseases.
·         Each year, approximately 5% of all 2-year olds will be diagnosed with croup along with many other children affected before or after age 2.

Croup is most commonly is caused by an acute viral infection.  Most cases occur during the late fall and winter months, but also can be seen throughout the year.  The viral infection typically begins in the nose and works its way down to the tissues surrounding the larynx (voice box).
·         The infection causes swelling of the tissue around the voice box.  This gives croup its classic symptoms of a "barking" cough, hoarse voice, and stridor (a high pitched, musical sound produced as air moves into the lungs) while the child takes a breath.

 Additional symptoms that can be seen in croup and many other viral illnesses are:
·         Fever
·         Nasal congestion
·         Cough
·         Runny nose
 Croup typically appears after 1-2 days of classic common cold symptoms like those listed above.

Is croup dangerous?
Nearly all children who are diagnosed with croup recover completely after a few days (usually 3-7 days).  Rarely do children have serious complications from croup that require hospitalization or further intensive medical treatment.
·         Croup is most commonly caused by the parainfluenza virus
o   Note that this virus is different from the well-known virus that causes the flu (influenza virus). 
o   Influenza is also a cause of croup along with RSV and adenovirus, among others.
§  Just another reason why it's important to get your flu shot every year!

How do I know if my child has croup?
The majority of cases are diagnosed by pediatricians and emergency room doctors simply based on the history and physical exam of the child.
·         Occasionally, further tests such as an x-ray can help to identify croup.
o   Any child with difficulty breathing, stridor, or a bark-like cough should be evaluated immediately by a physician.

How is croup treated?
The typical treatment for croup involves receiving one dose of steroids, either by mouth or with a shot in the muscle, followed by treatment with a medication delivered by an aerosol machine.
·         Most cases do not require further intervention other than medication for pain or fever and to encourage the child to drink fluids in order to prevent dehydration.
o   Antibiotics, which only kill bacteria, are not prescribed in the treatment and management of croup, which is almost always caused by a virus.
·         The best treatment is prevention!
o   Croup is spread via direct contact with infected people or surfaces. 
o   The best way to prevent spread is through frequent hand washing, avoiding sharing of cups and utensils, and cleaning areas which are touched by many people, especially kids!
·         Many years ago, croup was thought to be best treated by exposing a child to a cool mist spray directed at their mouth and nose, but many studies have failed to show that this treatment has any benefit.
o   Research has also shown that mist therapy, both warm and cold, can actually worsen symptoms and cause children to become more ill.

For more information on croup or other infections of the respiratory tract, please consult your pediatrician.

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