Croup is a common childhood medical condition that results in the swelling of the voice box (larynx), the windpipe (trachea) and the airways to the lungs (the bronchi). Children develop a characteristic barking cough and a harsh sound when breathing in (stridor). They may also developed a muffled and hoarse voice and breathing difficulties in severe cases.

What causes croup?

A number of virus can cause croup but most commonly it is the parainfluenzae virus. Often young children aged between 6 and 36 months are affected but no age group is spared. Croup is commoner in late autumn and early winter months and in boys.

How is croup treated?

Most cases of croup are mild and diagnosed by GP. They can be treated at home. However, if the symptoms are severe and the child finds it difficult to breathe, it is of utmost importance to act urgent and take the child to the nearest hospital’s accident and emergency (A&E) department.

Mild croup is better left alone as distressing the child as lead to worsening of symptoms. Ensuring that the child sits upright whilst comforting them is an effective supportive strategy. However the definitive treatment involves giving a dose of steroid (dexamethasone or prednisolone) is often need to reduce the swelling. Antibiotics are not indicated unless in severe cases where inpatient therapy with adrenaline nebulisers and oxygen along with ventilation support may be required. Most often croup improves within 48 hours, but rarely it may linger on for a couple of weeks. Reassuringly, it is extremely rare for a child to die from croup.

Can croup recur?

A child may experience croup more than once during childhood. However, other structural airway problems may also present like simple croup and with repeated occurrences, further investigations (bronchoscopy) is indicated in ruling out other causes.

Can we prevent croup?

Most cases are caused by virus and hence it is difficult to prevent. Nevertheless, good hygiene at home and routine childhood vaccinations (other organisms causing croup) is strongly advocated.

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