Croup is a convenient name for the condition of laryngotracheo-bronchitis. This is an inflammation of the voice box (larynx), the main air tube to the lungs (trachea), and the larger branching air tubes (the bronchi).

Croup affects young children over 3 months and under 3 years.  The flow of air into and out of the lungs is reduced by the swelling in the airways, and in severe cases this can make it very difficult for the child to breathe.

Causes

Croup is usually caused by a viral infection causing inflammatory swelling of the lining of the larynx and trachea.

Most cases of croup occur during the autumn and winter months.

Treatment

In most cases, children with croup recover after several days and require no medical treatment.  Make sure that they have plenty of fluids.

Increased humidity usually helps breathing, for example a steamy bathroom.  Alternatively, cold air may provide relief from an acute episode of croup, as long as the child is kept warm.

Children with more severe croup may benefit from a stay in hospital to receive oxygen therapy and monitoring.

Symptoms

The air passage through the larynx becomes narrower, so that breathing and coughing are difficult, harsh and painful. The voice is hoarse. Breathing in is often more difficult than breathing out, causing the characteristic crowing sound known as inspiratory stridor. There is often a typical ‘barking’ cough.

Sometimes the soft tissues of the neck, and the area below the ribcage, can be seen to be pulled inwards during attempts to breathe in.  This symptom requires medical attention.

The child may become very restless, with a fast pulse rate, difficulty in breathing, and rarely some blueness of the skin (cyanosis), particularly around the lips. A child who is blue or who cannot drink or talk is very ill, and urgent treatment at hospital is needed.