Croup
Suzanne Schuh
Introduction
Croup is a viral infection of the upper airway
Most commonly caused by parainfluenza virus
Most frequent in infants 6 months to 3 years of age but can occur up to 15 years of age
Clinical Presentation
Abrupt onset of barky cough frequently associated with stridor on inspiration, hoarseness, and respiratory distress
History
Onset usually during the night
Dog- or seal-like barking cough
Hoarse voice/cry
Respiratory distress and noisy breathing often improve upon exposure to cool night air en route to the emergency department
Duration of symptoms: 48 hours to 7 days
Practice Point
Consider epiglottitis if toxic appearance, drooling, and anxiety
Consider bacterial tracheitis if preexisting croup with sudden deterioration, toxic appearance, poor response to inhaled epinephrine
