Summary about Disease
Laryngotracheobronchitis, commonly known as croup, is an infection of the upper airways that causes swelling around the voice box (larynx), trachea (windpipe), and bronchi (large airways leading to the lungs). This swelling narrows the airway, making it difficult to breathe and causing a characteristic "barking" cough. It primarily affects young children, usually between 6 months and 3 years of age.
Symptoms
Barking cough (like a seal)
Stridor (a high-pitched, noisy breathing sound, especially when inhaling)
Hoarseness
Fever (may be present)
Runny nose
Sore throat
Difficulty breathing
Restlessness or agitation
Causes
Croup is most commonly caused by viral infections, primarily:
Parainfluenza viruses (types 1, 2, and 3) - most common
Respiratory syncytial virus (RSV)
Adenovirus
Influenza virus
Rhinovirus Less frequently, it can be caused by bacteria or triggered by allergies.
Medicine Used
Corticosteroids: Dexamethasone (oral or injectable) or Prednisolone (oral). These reduce inflammation in the airways.
Nebulized Epinephrine: Used for severe cases to quickly open the airways. The effect is temporary, but it provides immediate relief.
Supplemental Oxygen: For children with low oxygen levels.
Antipyretics: Medications like acetaminophen (Tylenol) or ibuprofen (Advil/Motrin) to reduce fever.
Avoid Cough medicine: Cough medicines are generally not recommended.
Is Communicable
Yes, croup is highly communicable. It spreads through respiratory droplets produced when an infected person coughs or sneezes. It can also spread through contact with contaminated surfaces.
Precautions
Handwashing: Frequent handwashing with soap and water.
Avoid close contact: Limit contact with infected individuals.
Cover coughs and sneezes: Use a tissue or your elbow to cover your mouth and nose when coughing or sneezing.
Clean and disinfect surfaces: Regularly clean and disinfect frequently touched surfaces.
Stay home when sick: Keep children home from daycare or school if they have symptoms.
Vaccination: While there is no vaccine for parainfluenza viruses (the most common cause), staying up to date on recommended vaccines, like the influenza vaccine, can help prevent croup caused by those viruses.
How long does an outbreak last?
Croup typically lasts for 3 to 7 days. Symptoms usually peak around day 3.
How is it diagnosed?
Diagnosis is usually based on a physical examination and the characteristic symptoms, particularly the barking cough and stridor. A doctor will listen to the child's breathing and assess the severity of the symptoms. X-rays are rarely needed, but may be used in severe cases or if other conditions are suspected.
Timeline of Symptoms
Day 1-2: Mild cold-like symptoms, such as a runny nose, sore throat, and low-grade fever.
Day 2-3: Development of the characteristic barking cough, hoarseness, and stridor. Symptoms may worsen at night. Fever may increase.
Day 3-5: Symptoms usually peak around day 3. The barking cough and stridor may be most pronounced during this period.
Day 5-7: Gradual improvement in symptoms. The cough becomes less frequent and the stridor diminishes.
Beyond Day 7: Symptoms usually resolve completely within a week, though a mild cough may persist for a few days longer.
Important Considerations
Severity: Croup can range from mild to severe. Severe cases require immediate medical attention.
Respiratory Distress: Watch for signs of respiratory distress, such as rapid breathing, difficulty breathing, retractions (pulling in of the skin between the ribs or above the sternum), and cyanosis (bluish discoloration of the skin).
Recurrent Croup: Some children are prone to recurrent episodes of croup.
Age: Croup is most common in young children but can occasionally occur in older children.
Hydration: Ensure adequate fluid intake to prevent dehydration.
Humidity: Cool mist humidifiers or steamy bathrooms may help to ease breathing. However, their effectiveness is debated.
Medical Advice: Always consult a doctor for diagnosis and treatment, especially if symptoms are severe or if you are concerned about your child's breathing.