Croup (sometimes referred to as croup syndrome or laryngotracheobronchitis)or the trem whooping cough sometimes comes up, is a respiratory disease which afflicts infants and young children, typically aged between 3 months and 5 years. The respiratory symptoms are caused by inflammation of the larynx and upper airway, with resultant narrowing of the airway. Croup is characterized by a harsh 'barking' cough, stridor (a high-pitched sound heard on inhalation) and fever. Hoarseness is usually present. More severe cases will have respiratory distress.
The 'barking' cough (often described as a "seal like bark")of croup is diagnostic. Stridor will be provoked or worsened by agitation or crying. If stridor is also heard when the child is calm, critical narrowing of the airway may be imminent.
In diagnosing croup, it is important for the physician to consider and exclude other causes of shortness of breath and stridor, such as foreign body aspiration and epiglottitis.
On a frontal X-ray of the C-spine, the steeple sign suggests the diagnosis of croup. Croup is most often caused by parainfluenza virus, primarily types 1 and 3, but other viral and possibly bacterial infections can also cause it. It is most common in the autumn but can occur year-round, with a slight predilection for males.
The respiratory distress is caused by the inflammatory response to the infection, rather than the by infection itself. It usually occurs in young children as their airways are smaller and differently shaped than adults, making them more susceptible. There is some element of genetic predisposition as children in some families are more susceptible than others.
An entity known as spasmodic croup also occurs, due to laryngeal spasms.
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