Dr. Ayush PandeyMBBS,PG Diploma

November 30, 2018

March 06, 2020


What is croup?

Croup is a respiratory illness that commonly affects children in the age group of six months to three years. It is a condition of the upper airway resulting from swelling of the voice box, windpipe and bronchi. This swelling ultimately leads to obstruction of the airways producing a noisy cough.

What are its main signs and symptoms?

Symptoms of croup are usually worse at night. They also fluctuate rapidly depending on whether the child is calm or irritated.

  • Late symptoms:
    • Hoarseness of voice
    • Harsh, ‘barking’ cough (known as seal’s bark)
    • High-pitched noise when inhaling (stridor)
    • Rapid or laboured breathing
  • Symptoms in severe cases:
    • Confusion and lethargic behaviour
    • Problems with feeding and drinking
    • Difficulty while speaking
    • Chest indrawing (inward movement of the lower chest wall when breathing in)
    • Bluish tinge around the mouth

What are its main causes?

The most common cause of croup is a viral infection by the parainfluenza virus. It primarily transmits through droplets of cough spreading in the air when an infected person coughs or sneezes.

Infection of the respiratory tract causes oedema and inflammation of the upper airway and laryngeal mucosa, resulting in narrowing of the passage through which air enters the lungs. This leads to difficulty in breathing.

How is it diagnosed and treated?

Medical history and clinical examination aid in diagnosing croup.

Your physician may also recommend tests for investigation, which include:

  • Chest and neck X-ray
  • Blood tests to detect and confirm infection

Treatment depends on the age, health and history of the patient.

Treatment involves:

  • Inhaled medicines to relieve the difficulty in breathing
  • Steroids (injected or oral)
  • Medications for allergy or reflux


  • It helps to keep your child calm. Being agitated can worsen the trouble breathing.
  • Offer plenty of fluids to the child, but in small sips.
  • The child should be seated upright or propped up in bed with pillows to make breathing easier.
  • Strictly avoid smoking at home. Smoke can aggravate symptoms of croup.


  1. St. Louis Children's Hospital. [Internet]. Washington University, St. Louis, Missouri. Croup
  2. Dustin K. Smith. Croup: Diagnosis and Management. American Academy of Family Physicians. [Internet]
  3. Candice L. Bjornson. Croup in children. CMAJ. 2013 Oct 15;185(15):1317-23. PMID: 23939212
  4. Batra P. An evidence-based approach to evaluation and management of the febrile child in Indian emergency department. Int J Crit Illn Inj Sci. 2018 Apr-Jun; 8(2): 63–72. PMID: 29963408
  5. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Croup