What Is Croup?

Croup is a respiratory infection that affects babies and young children. The most common cause of croup is a viral infection. Croup occurs when the voice box (larynx) and windpipe (trachea) become inflamed and swollen. The inflammation causes a narrowing of the airway, which produces a cough similar to a seal’s bark and raspy breathing.

Croup usually only affects children 3 years of age or younger. This is likely due to their smaller windpipes (tracheas), which grow larger as they age, making croup less common. Although croup is typically mild, it can become severe or even life-threatening in some children.

Causes

The most common cause of croup is a viral infection. Viruses that may cause croup include parainfluenza, influenza, respiratory syncytial virus (RSV), adenovirus, and measles. Other causes of croup may include environmental irritants such as smoke, asbestos, dust, or another allergen. In some cases, croup that comes on suddenly in the middle of the night may be due to reflux, when stomach contents move back up into the esophagus.

Is Croup Contagious?

Croup is highly contagious, especially within the first 3 days, or until there is no fever present. Virus particles are spread through respiratory droplets in coughs and sneezes. To prevent contagion, make sure to regularly wash hands and disinfect surfaces. Additionally, if you or someone in your household has croup, staying home and masking around others may also help to prevent contagion.

Can Adults Get Croup from Taking Care of a Child?

It is possible for adults or older children to get croup, although it is less common due to larger airways. If an adult gets croup, it tends to be more severe, and it is more common to need to see a doctor.

Symptoms

Symptoms of croup often begin like a common cold. As it progresses, if there is swelling or inflammation of the airway, symptoms may include:

• Loud, barking cough that sounds like a seal bark
• Raspy or labored breathing
• Fever
• Hoarse voice
• Anxiety and stress can worsen symptoms of cough and breathing
• Coughing and breathing issues tend to get worse at night
• Rash
• Eye redness (conjunctivitis)
• Swollen lymph nodes

Symptoms tend to last 3-5 days. If symptoms worsen or the following symptoms are exhibited, please seek medical attention:

• Breathing (inhale or exhale) produces a noisy high-pitched sound
• The high-pitched noisy breathing sound occurs when not crying or upset
• Difficulties swallowing or noticeable drooling
• Anxiety and restlessness
• Fatigue, lethargy, or no energy
• Faster than normal breathing rate
• Difficulties breathing
• Retractions (the skin appears sucked in around your child’s ribs and the top of their breastbone)
• Blue or gray tint in or around the nose or mouth, or on the fingernails (cyanosis)

Difference Between Croup in Children vs. Adults

Children and babies are more likely to develop croup because they have smaller airways. Croup is less likely as you age because your airways grow larger. Adults who do develop croup tend to have more severe symptoms and usually need to see a doctor.

Will Croup Go Away on Its Own?

In most cases, croup symptoms will resolve in two days. In other cases, symptoms may last up to a week.

Treatment

Treatment of croup varies depending on the severity of symptoms. If it is a mild case of croup, most symptoms resolve in a few days. If symptoms are more moderate to severe, different treatment options may be recommended. Treatments include:

Mild

Mild croup does not typically require a visit to the doctor and can be treated at home. One of the best ways of treating mild croup is using a cool mist humidifier, or having your child sit in the bathroom with a hot steaming shower going. The steam from the shower will help soothe the dry and irritated airways. Other at-home remedies include:

• Over-the-counter medications, such as ibuprofen or acetaminophen
• Opening a window to let cool air in
• Warm, clear fluids to help loosen the mucus from the vocal cords
• No smoking (cigarette smoke is an irritant to the airways)
• Children (not infants) can use extra pillows to keep their head elevated

Moderate to Severe

If you or your child has moderate to severe croup, you should go to the nearest Urgent Care or emergency room. Severe croup can be life-threatening and must be treated immediately. Treatment for moderate to severe croup will depend on symptoms and severity. Treatments may include:

• Oxygen or humidified air
• IV fluids to treat dehydration
• Monitoring vital signs
• Croup medications (steroids, such as glucocorticoids and nebulized breathing treatments using epinephrine)
• In rare cases, placement of a breathing tube (mechanical ventilation)

When to See a Doctor?

If your child is having difficulties breathing or has a fever that has lasted longer than 3 days, please seek medical care. Find a Baptist Health doctor today!