Croup is a respiratory tract infection that can cause a swelling in the larynx, which is your voice box and the upper airways. It is almost always caused by a virus, in particular by the para influenza virus. It is frequently seen in the age groups between 3 months to 3 years but may occur in older children. More commonly it occurs during fall and the winter season.

The symptoms usually start with an initial 1 to 5 day occurrence of cough, cold and low grade fever. This then progresses into a hoarseness of the voice and the classic bark like cough which worsens at night. This may last anywhere between 2 to 5 days. There may be a harsh musical sound on breathing in called as the strider, which is present or exacerbated upon crying or on physical activity.
What can we do for these patients with croup? As with any viral infection, rest and plenty of fluids always helps. Breathing in humidified air using a humidifier or a vaporizer in the room keeps the airway moisturized. During a midnight croup attack, turn up the hot shower in the bathroom, sit with the child in the steam for at least 10 to 15 minutes. Steam almost always works, breathing in cool night air also helps sometimes. Now, when to seek urgent medical care? If the croupy cough and strider is not relieved by steam or if the child has difficulty in breathing or is breathing fast with retractions under the ribs, if drooling is present, if there is a bluish discolouration of the lips and the finger tips or if the child appears sleepy or lethargic or if the fevers are high and if the child is not drinking much, definitely take your child to the emergency room. Now, in-terms of treatment cool mist humidification therapy is the main stay of treatment which can happen at home for mild croup. Now, severe croup is managed in the hospital with medication given through a mask and nebulizer, steroids and humidified oxygen and usually there is no role for antibiotics here as croup is almost always viral.

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