$Unique_ID{PAR00049}
$Pretitle{}
$Title{Medical Advice:  Croup}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Croup Barking cough coughing Hoarseness breathing Difficulty inhaling
Crowing sound Epiglottitis Fever swallowing Sore throat Drooling Sitting head
forward mouth open tongue hanging inflammation larynx voice box}
$Log{
Croup in the Lungs*0004901.tif}

Your Child:  A Medical Guide


Croup


     Quick Reference

     SYMPTOMS
     Croup:
     - Barking cough
     - Hoarseness
     - Difficulty in breathing, especially inhaling
     - Crowing sound when inhaling

     Epiglottitis:
     - Fever (as high as 105 degrees_F)
     - Difficulty in breathing
     - Difficulty in swallowing
     - Sore throat
     - Drooling
     - Sitting with head forward, mouth open, and tongue hanging out

     HOME CARE
     - If a child has serious difficulty in breathing, do not treat at home.
       Notify your doctor, and go immediately to the nearest hospital
       emergency room.
     - For mild, repeated attacks of croup (if there is no serious breathing
       problem), add moisture to the air to make breathing easier.  Use a
       vaporizer or humidifier.  Sit with the child in a closed bathroom with
       a hot shower running to build steam.  If steam does not relieve the
       symptoms, call your doctor.
     - The first time you suspect that your child has croup (even a mild
       case), call your doctor.

     PRECAUTIONS
     - If your child has a high fever, has difficulty in breathing and
       swallowing, is drooling, or sits with the head forward, mouth open, and
       tongue hanging out, get medical help immediately.
     - Do not give cough medicine to a child who has croup or any difficulty
       in breathing.
     - Do not give ipecac to a child with croup.


     Croup is an inflammation and swelling of the larynx (voice box), usually
caused by an infection.  Croup is common and is passed on in the same manner
as a common cold--by airborne droplets or by direct contact with an infected
person.
     Croup causes a tight, dry, barking cough and hoarseness.  Difficulty in
breathing develops quickly, with more trouble in inhaling than exhaling.
Efforts to inhale cause the crowing sound that is typical with croup.  (This
is in contrast to asthma, in which there is more difficulty in exhaling and a
wheezing sound is heard when the child breathes out.)  Croup can be serious,
but milder cases, especially repeated ones, can usually be handled safely at
home.
     There is a form of croup, epiglottitis, that is a life-threatening
illness--a true emergency in which minutes count.  It is a bacterial infection
of the epiglottis (the lid-like structure that covers the entrance to the
larynx) and surrounding tissues.  It is most common in children between the
ages of three and nine years.  The fever may rise to 105 degrees_F.  The
difficulty in breathing quickly becomes severe.  The child drools, has trouble
swallowing, and prefers to sit with the head forward, mouth open, and tongue
partially out.  The condition rapidly progresses to choking and
convulsions--it must be treated immediately.

SIGNS AND SYMPTOMS

     The key symptoms of croup are a barking cough, hoarseness, difficulty in
breathing, and a crowing sound heard when inhaling.  There may be no fever or
only a low-grade fever (101 degrees_F).
     It is important to be always watchful for the signs of epiglottitis:  a
high fever, difficulty in breathing and swallowing, sore throat, drooling, and
preference for the characteristic position of sitting with the head forward,
mouth open, and tongue partially out.
     Choking on a foreign object may resemble croup, since both share the same
symptom of frantic efforts to breathe.  However, it is easy to tell choking
from croup by one important distinction--a choking child cannot speak or cry
out, but a child with croup can do both.

HOME CARE

     If a child has a serious breathing difficulty, do not try to care for him
at home.  Notify your doctor, and head for the nearest hospital emergency
room.
     Mild, repeated attacks of croup can often be cared for at home (if there
is no serious difficulty in breathing).  However, it is best to call your
doctor the first time you suspect that your child has croup.
     The basic home care for mild attacks is adding moisture to the air to
relieve the cough and help the child breathe more easily.  A humidifier or
vaporizer will be helpful.  (Be sure to keep it meticulously clean, however.
Otherwise, it can actually become a source of infection if microorganisms are
allowed to grow in it.)  Steam also may be generated quickly by running a hot
shower in a closed bathroom.  Sit in the room with your child for a short
while.  If the symptoms are not relieved, call your doctor.

PRECAUTIONS

  -  If your child has a high fever, has difficulty in breathing and
     swallowing, is drooling, or sits with the head forward, mouth open, and
     tongue hanging out, get medical help immediately.
  -  Never give any type of cough medicine to a child with croup or any
     difficulty in breathing.
  -  Do not give ipecac as a home treatment for croup.  Ipecac may make
     breathing even more difficult.

MEDICAL TREATMENT

     Mild cases of croup can usually be treated at home.  In severe cases, the
child will be hospitalized, and a croup tent, which provides high humidity,
will be used.  The doctor may also order an x-ray examination, cultures, and
blood tests.  If the condition becomes severe, intubation (insertion of a tube
into the airway) may be necessary.
     Epiglottitis is always treated as an emergency.  The doctor will intubate
the child or perform a tracheotomy (in which an opening is made surgically in
the windpipe).  Intravenous fluids and antibiotics will be given, and the
child's condition will be carefully watched.

RELATED TOPICS:  Asthma; Choking; Convulsions with fever; Fever