Croup typically starts with mild cold-like symptoms such as a runny nose, low-grade fever, and a generic cough. Over 24–48 hours, the cough evolves into the characteristic bark-like sound, especially noticeable at night when symptoms peak due to naturally reduced airway diameter during sleep. Stridor, especially during inspiration, can alarm parents and signals narrowing airways.
Diagnosis of croup is primarily clinical, based on symptom history and physical examination. In rare cases, imaging or tests are performed to rule out other causes of airway obstruction. The condition is generally mild and self-limiting, resolving within 3–7 days. Treatment often involves at-home care, emphasizing hydration and exposure to moist air, such as from a humidifier or a steamy bathroom, to soothe inflamed airways. Medications like corticosteroids (e.g., dexamethasone) are prescribed for moderate to severe cases to reduce inflammation swiftly, while nebulized epinephrine is reserved for critical cases in hospital settings.
While croup is usually non-threatening, its severity can range from mild to life-threatening. Early signs of severe disease include persistent stridor at rest, retractions (visible sinking of skin around the ribs), cyanosis (bluish skin due to lack of oxygen), and lethargy. These warrant immediate medical attention.
Recent advancements in understanding croup have emphasized the role of vaccination in prevention. Vaccines against influenza and RSV, along with good hygiene practices, significantly reduce viral transmission and incidence. Educating caregivers on symptom recognition and when to seek help remains vital in reducing anxiety and ensuring timely care. With proper management, most children recover fully and quickly.
Croup in Young Children: Identification and Care
