CROUP

Normal Larynx Inflamed Larynx

Trachea Croup is a symptom,

characterized by infection
and inflammation of the upper air-
Vocal chords way (trachea and larynx)

Etiologies Pathophysiology
Viral infection of the laryngeal mucosa
Viral causes Bacterial causes
Imflammation, hyperemia, epithelial necrosis and shredding
• Parainfluenza viruses types 1 • Staphylococcus aureus ⊲ results narrowing of the subglottic region
and 3 (80% of cases) • Streptococcus pyogenes
• Influenza virus A and B Breathe more rapidly and deeper to compensate for the
• Streptococcus pneumoniae
narrowing of the upper airway
• Respiratory syncytial virus • Haemophilus influenzae
(RSV) Turbulent airflow (stridor) through the upper airway, chest
• Moraxella catarrhalis
• Adenovirus wall begins to retract
• Rhinovirus Inefficient asynchronous chest and abdominal movement,
fatigued

Signs & Symptoms
Typically starts as mild cold
Cough: loud barking
Respiratory: difficulty
breathing, fast breathing,
noisy breathing, short-
ness of breath, whee-
zing, or stridor
Also common: agitation,
anxiety, phlegm, or sore
throat
Nasal: congestion or
runny nose
Treatment
Speech: hoarseness, or
impaired voice
Time: worse at night
For most children, croup is a
mild illness that can be mana-
ged at home
Hyproxia and hypercapnia, progress to respiratory failure and
arrest
Corticosteroids (dexamethasone, predni-
sone)
In serious cases: racemic epinephrine
nebullizer
Acetaminophen and/or Ibuprofen (only > 6
months old)
Humidified air ― debatable efficacy

Diagnosis Complications
History of symptoms Secondary bacterial infections
Complications
Physical exam Dehydration
are rare.
Barking cough, hoarseness, inspiratory stridor Respiratory distress

Low-grade fever May need oxygen support, fluids

and racemic epinephrine
Absence of wheezing

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