Croup is a respiratory illness caused by the parainfluenza virus (a cousin of the flu) and can affect anyone from infancy through adulthood. The condition causes inflammation in the back of the throat, windpipe and upper portion of the lungs. It’s more dangerous for younger children, particularly those under school age, because the complications of croup can cause swelling in the back of the throat that can nearly close it off. This means a baby or toddler isn’t getting enough oxygen.
Most people quickly recognize the most common symptom of croup – a very barky, hoarse cough that sounds like a dog or a seal. Children who have the croup can also sound like a frog when they talk. Adults may develop laryngitis from the croup, but it’s not nearly as dangerous because of the larger diameter of their airway.
More worrisome symptoms of the croup are chest congestion, high fever up to 103 degree F, and strider. Strider is the high-pitched, squeaking or whistling sound a person makes when they breath in from their throat and don’t get enough air. It’s a very harsh and loud sound caused by the obstructed airway. Babies with strider tend to have retractions (where the muscles under, above or between the rib cage tighten with every breath), along with being lethargic or be difficult to wake up.
With croup, the infection isn’t down deep in the lungs – it’s in the windpipe area. When you hear the high-pitched sound, you know the restriction is at the top of the throat going down into the lungs. This is different from other lung related diseases because it can become an emergency very quickly.
Symptoms of the croup are often worse at nighttime. The best treatments for mild to moderate cases of croup (with no difficulty breathing) are a cool mist humidifier, cold air from the freezer or going outside. If your child has croup in the fall or winter, wrap up in a blanket and sit on the porch and breathe in the night air. This can make a surprisingly big difference in symptoms. If this doesn’t help resolve them, the next step is to see your pediatrician for a dose of steroids.
Decadron is the treatment of choice – given by shot or as a drink in the office. One dose lasts about five days in the body. Steroids open the airways, reduce swelling in the throat so air can move through more easily. In most cases, this helps patients get through the worst of the illness, which is the first five to seven days.
Unlike the common cold or other respiratory conditions, I counsel my patients to be aggressive in the treatment for croup. My own child once went to bed with a little cough and woke up with very bad strider and was completely lethargic. There was nothing I could do at home but go straight to the emergency room. When symptoms are worsening, it’s important to get the steroids early – which can help prevent an emergency room visit. The steroids can often address the symptoms long enough for the body to fight off the viral infection.
All in all, the hard barking sound associated with croup lasts about a week and a few weeks more for the leftover cough and congestion to subside. During this time, it’s a good idea to practice good handwashing and masking to help prevent spreading the virus to someone else.
Learn more about CHI Memorial Pediatric Diagnostic Associates. To schedule an appointment with Dr. Campbell, call 423.698.BABY (2229).