Croup or Laryngotracheobronchitis : Everything You Need To Know

Croup or Laryngotracheobronchitis is an infectious ailment found in children. It involves the respiratory system and also includes the larynx or the vocal cords, the trachea or the windpipe, and bronchial tubes, which forms the upper airways of the lungs. It is a term given to swelling around the larynx or the vocal cords. It is generally a viral infection and there are many viruses responsible for causing croup, including the common cold and influenza viruses. On rare occasions is croup or laryngotracheobronchitis caused by a bacteria. This illness is more common in children between three months to six years of age, and very rarely in children above the age of six. Croup is seasonal and is seen to affect children between the months of October and March. Croup is generally found more in boys than girls.

• Viral infections
• Bacterial infections
• Allergies
• Inhaling something which can potentially irritate the airways.
• Acid reflux

The viral infections that generally cause croup or laryngotracheobronchitis are parainfluenza viruses, Reflex Simplex Virus, Measles, adenovirus, and influenza viruses.

The following are some of the common facts of croup or laryngotracheobronchitis that parents should know about:

• Croup is an infection of larynx, trachea, and bronchial tubes which is generally caused by viruses and very rarely by bacteria.
• Laryngotracheobronchitis is a contagious illness, particularly during the initial phase of the illness.
• A cough sounding like a “bark” with a raspy sound or barking cough with inspiration are the symptoms of croup.
• One of the major concerning factors in laryngotracheobronchitis is the progressive difficulty with breathing because of the air passages getting narrowed.
• It is of paramount importance to observe child’s breathing in case of croup or Laryngotracheobronchitis, particularly at nighttime.

• A child suffering from croup will have symptoms generally caused by swelling of the larynx or the vocal cords. The common symptoms that a child suffering from croup will have are fever up to 103 degrees Fahrenheit with a little bit of hoarseness and sore throat for a couple of days, immediately followed by barking cough with a raspy sound while breathing. These symptoms generally last for around a week.
• There may be another presentation for a child suffering from croup or Laryngotracheobronchitis in that a child may be perfectly all right when put to bed at night but will then wake up shortly thereafter with “barking” cough and raspy sound with inhalation which may be present for a few hours and then the symptoms abate, only to recur again at night. This pattern may continue for a few days before the other symptoms of croup start emerging.
• The two different types of symptoms mentioned above can be a result of the particular virus that has infected the child. How severe the symptoms of Croup or Laryngotracheobronchitis are depends on how much narrow the airway has become.

Croup or Laryngotracheobronchitis is generally diagnosed depending on description of the symptoms provided by parents along with a physical exam. Physical examination may show chest retractions on breathing. When the physician listens to chest he may hear prolonged inhalation or exhalation, wheezing, and decreased breath sounds. Throat examination may reveal a reddened epiglottis.

Listed below are some of the precautions that parents may follow to ensure that their child does not get infected with Croup or Laryngotracheobronchitis:

• Wash your hands frequently
• Avoid close contact with individuals suffering from respiratory infections.
• Make sure that the child is given diphtheria, Haemophilus influenzae, and measles vaccines since it protects the child from most of the potentially serious forms of croup.

• Majority of the cases of croup or Laryngotracheobronchitis can be managed adequately and safely at home but guidance needs to be taken from a physician.
• Moist or cool air generally brings relief. This can be done by bringing the child in an environment where there is moist air like a steamy bathroom. One can also use vaporizers for relief of symptoms.
• The fever accompanying laryngotracheobronchitis can be addressed by giving the child acetaminophen. It may also improve the breathing quality of the child.
• Steroids may also be very effective for relief of symptoms of croup or Laryngotracheobronchitis.
• To reduce the swelling of the upper airway corticosteroids like dexamethasone and prednisone may be used. Antibiotic therapy is required in case of croup caused by a bacterial infection.
• In case of severe obstruction of airway, intubation may be required so as to allow easy passage of air to the lungs.

Like in every illness there are some complications, in case of croup or Laryngotracheobronchitis the following are some of the complications:

• Respiratory distress
• Epiglottitis
• Atelectasis
• Dehydration

Croup or Laryngotracheobronchitis tends to last for almost a week in majority of cases with timely treatment but in some cases it may even take a longer time to recover. With treatment, Barking sound of the cough and the stridor will improve in 3 to 4 days, but the other general and less severe symptoms may continue for few additional days.

As stated above, majority of croup or Laryngotracheobronchitis cases can be managed at home but in case of the following symptoms, you need to contact your healthcare provider immediately.

• Croup that may possibly be caused by insect bite or inhalation of an irritant
• Development of cyanosis or bluish discoloration of lips and skin
• Drooling
• Dysphagia
• Stridor
• Retractions
• Dyspnea
• The child becomes extremely irritable and agitated
• There is no response to home remedies.
• Moment you notice your child having barking cough, it is better to show him to a physician.

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Also Read:

• Whooping Cough or Pertussis
• Rib Pain Due To Coughing
• Sore Throat and Ear Pain
• Bacterial Bronchitis
• Throat Pain Due To Bacterial Laryngitis
• Throat Pain Due To Viral Laryngitis
• Strep Throat or Group A Streptococcus