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Pediatrics : Croup
Croup is usually a benign, self-limited viral illness involving the upper airway and trachea (just below the vocal cords). The common age range in which croup is seen is 6 months to 4 years but, occasionally, it may be seen in the older child (7-10 years). Common symptoms include the presence of 2-3 days of a typical "cold" with runny nose. The condition worsens with a "barky" cough, which is more pronounced at night and very early in the morning. The patient with acute croup will make a wheezy sound when breathing air IN (opposite of the asthmatic). The noisy inhalation is referred to as stridor. Croup will normally run its course in 3-4 days. There may be a low grade fever associated with this illness. Evaluation will include a medical history and physical examination. Your physician will be looking for clues to distinguish between croup and a more SERIOUS related illness known as epiglottitis. Both problems will include stridor, but epiglottitis will have a more sudden onset with high fever, drooling, and difficulty swallowing. Soft tissue x-rays of the neck will help the doctor exclude the more serious possibility. Treatment of confirmed cases of croup usually require acetaminophen for fever control and airway support during the croupy period of the day. These patients respond well to increased humidity and will frequently benefit from spending some time in a steamy bathroom, (run hot shower) or with a vaporizer (coolmist) Children taken out into the damp night air are often better by the time they get to the emergency room. Antibiotics are not generally indicated unless a bacterial source (e.g. ear infection, tonsillitis, etc.) is identified. Hospitalization is necessary for a small percentage of croup patients who do not respond to the above measures. Any child with a bout of difficulty breathing and stridor DURING THE DAY TIME will likely require admission, to alleviate concern over more pronounced breathing difficulty in the forthcoming night.
Hope this article will provide you information about pediatrics : croup.
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