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ID: 181
Category: Infection
CreatedBy: 1
UpdatedBy: 1
createdon: 16 Feb 2023
updatedon: 24 May 2023

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Author: Khoa Tran
Published Feb 16, 2023
Updated May 24, 2023

Table of contents

Croup

Etymology and Pronunciation

croup (kroop)
croupe - Old french for "rump" or "haunch"

History of Croup

Croup is a respiratory disease that affects young children and causes inflammation of the upper airway.

In the 1960s, when children had croup, parents would take them to the bathroom and run a hot shower to help with their symptoms. If that didn't work, they would go to the emergency room. Sometimes, just being outside in the cool air would make the child feel better on the way to the hospital. At the hospital, they had special tents or rooms with cold mist for the children with croup. However, these rooms were not pleasant for the nursing staff. In severe cases, a tracheotomy was done as a last resort because intubation wasn't well-practiced at the time. Recent studies have shown that cool mist doesn't have much benefit and is rarely used now.

In the 1970s, emergency departments started using a medication called nebulized epinephrine for croup. It was helpful in preventing hospital admissions. The dose was 5 mL of a solution containing 1:1000 L-epinephrine. Another study compared this medication with another type of epinephrine called racemic epinephrine and found no difference between the two. However, one issue with nebulized epinephrine was the rebound effect, which occurred a few hours after treatment if a child was sent home too early. Many children had to return to the hospital and be admitted.

The discovery of viruses in the late 19th and early 20th centuries was a significant breakthrough in understanding the cause of croup. The development of electron microscopy in the 1940s allowed the visualization of the virus, further confirming its link to croup.

Other technological advancements, such as X-rays and bronchoscopy, have also contributed to the diagnosis and treatment of croup. X-rays can help identify the severity of inflammation and narrowing of the airway, while bronchoscopy can be used to directly visualize the airway and remove any obstructions.

Croup is easy to diagnose because of its specific symptoms. In some cases, a neck X-ray can help distinguish croup from other conditions like epiglottitis or a foreign object in the airway.

Modern Understanding of Croup

Croup is a respiratory illness that primarily affects infants and young children. It is caused by a viral infection that leads to swelling and inflammation of the larynx (voice box) and trachea (windpipe). This inflammation can result in a characteristic "barking" cough and difficulty breathing.

Croup is usually a mild illness and can be managed at home with supportive care, such as providing plenty of fluids, using a humidifier to moisten the air, and administering over-the-counter pain relievers and fever reducers. However, in severe cases, hospitalization may be necessary. Severe symptoms of croup include difficulty breathing, rapid breathing, and extreme fatigue.

When symptoms of airway swelling are more severe, the use of epinephrine has been shown to be effective in reducing them. The medicine can be administered through a nebulizer in an inhaled form, and while it works quickly, its effects wear off rapidly.

Causes of Croup

Croup is a viral infection that affects the airways, causing inflammation of the larynx (voice box), trachea (windpipe) and bronchi (airways in the lungs). The most common cause for Croup is a viral infection called parainfluenza virus. Other viruses that can cause Croup include influenza, respiratory syncytial virus (RSV), adenovirus and measles. The virus enters the body through the nose and mouth, and it spreads in the respiratory tract from there. Croup is more common in children, especially those below the age of 5, because their airways are still developing and smaller in diameter. Children with weak immune systems or who have a history of lung diseases are also more prone to develop Croup. Environmental factors such as exposure to tobacco smoke, cold weather or changes in temperature can also trigger Croup.

Treatments for Croup

Croup is a respiratory infection that mostly affects children below the age of five. The good news is that many children recover from it without any special treatment. However, in severe cases, medical assistance may be needed. Here are the treatments for croup:

- Home remedies: To manage symptoms at home, you can use a humidifier or take your child into a steamy bathroom for 10-15 minutes. You can also offer them plenty of fluids, cool or warm, to help prevent dehydration.
- Medications: If the symptoms worsen, doctors may prescribe medications such as steroids or epinephrine to reduce swelling in the airways.
- Hospitalization: In rare cases, severe croup may require hospitalization, where doctors can provide oxygen and monitor your child's condition closely.

It's important to note that croup is contagious and spread through respiratory droplets, so it's vital to ensure good hygiene practices, such as washing hands regularly, to avoid infection. If you suspect that your child has croup, please contact a doctor for recommendations on the best course of treatment.

Lifestyle Changes

While croup is generally managed through medical treatment. There are some measures that can help alleviate symptoms and support recovery. Here are a few suggestions:

- Humidify the air: Dry air can worsen croup symptoms, so using a cool-mist humidifier or sitting in a steamy bathroom can help add moisture to the air and ease breathing. Ensure the humidifier is properly cleaned to prevent the growth of mold or bacteria.
- Keep the child hydrated: Encourage your child to drink plenty of fluids, such as water or warm herbal teas, to help soothe their throat and prevent dehydration.
- Provide comfort and rest: Make sure your child gets plenty of rest and avoid activities that may exacerbate their symptoms. Providing a calm and comforting environment can help them feel more at ease.
- Avoid irritants: Smoke, allergens, and other irritants can worsen croup symptoms. Keep the child away from cigarette smoke and minimize exposure to environmental triggers such as dust, pet dander, or strong chemical odors.
- Use a saline nasal spray: If your child is experiencing nasal congestion alongside croup, using a saline nasal spray can help moisten the nasal passages and alleviate congestion. Follow the instructions on the product or consult a healthcare professional.
- Offer warm fluids: Warm liquids like chicken broth or warm water with honey and lemon can help soothe the throat and provide temporary relief from coughing. Honey should not be given to children under one year of age due to the risk of botulism.
- Follow the healthcare provider's recommendations: Croup may require medical intervention, such as corticosteroids or nebulized treatments. It is essential to follow the guidance of your child's healthcare provider and administer any prescribed medications or treatments as instructed.

It is important to note that croup can vary in severity, and severe cases may require immediate medical attention. Always consult a healthcare professional for an accurate diagnosis, appropriate treatment options, and guidance on managing croup symptoms.

Symptoms

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1121
Painful / loud barking cough
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High-pitched breathing called stridor
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Difficulty breathing
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Hoarse voice
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1125
Fever
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Nasal congestion / stuffy nose

Confirmation Tests

- Physical examination
- X-rays

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