Croup

Subject: Child Health Nursing

Overview

Inflammation of the voice box (larynx) and windpipe is a symptom of the illness croup (trachea). In particular when a youngster screams, it frequently results in a barking cough or hoarseness. The majority of croup cases are brought on by viruses, often parainfluenza virus but occasionally adenovirus or respiratory syncytial virus as well (RSV). Youngsters aged 6 months to 3 years are more likely to have viral croup, and those children also tend to experience its most severe symptoms. When they have a viral upper respiratory infection, some children are more vulnerable to getting croup. Laryngeal diphtheria, bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis are different types of bacterial croup. The symptoms of croup include a "barking" cough, stridor, hoarseness, and breathing difficulties that typically get worse at night. It's common to compare the "barking" of a cough to the sound of a seal or sea lion. Viral croup typically has milder cases, but not always. The majority of children find that breathing in the humid air makes them feel better, and ibuprofen or acetaminophen (only in infants over 6 months old) may help them feel more comfortable. Rest and a lot of fluids are advised, as with most diseases. A youngster with croup may also need oxygen, and occasionally they are kept overnight in the hospital for observation.

Croup

Croup is a respiratory illness of the upper airway that typically affects youngsters and results in wheezing and a barking cough.

Croup is characterized by coughing and other symptoms brought on by inflammation of the larynx, trachea, and bronchi. The enlarged vocal chords create a noise that sounds like a seal barking when a cough drives air through this constrained path.

Causes

Virus infection, primarily caused by the parainfluenza virus, is the typical cause of croup. By inhaling an infectious respiratory droplet that has been coughed or sneezed into the air, a kid can contract croup. Children who come into contact with toys or other objects and then touch their eyes, noses, or mouths could contract the virus.

Pathophysiology:

The viral infection that causes croup causes the larynx, trachea, and major bronchi to enlarge as a result of white blood cell invasion (especially histiocytes, lymphocytes, plasma cells, and neutrophils). Swelling causes airway blockage, which, when severe, causes a considerable increase in the amount of labor required to breathe and the distinctively turbulent, noisy airflow known as stridor.

Signs and symptoms:

  • Barking cough
  • Mild fever
  • sore throat
  • noisy breathing
  • rashes
  • conjunctivitis
  • anxiety
  • hypoxia
  • cyanosis

Diagnosis:

  • X-ray show the top of the airway narrowing to a point.
  • Nasopharyngeal aspirate
  • Physical examination: a barking cough and stridor
  • History taking: fever, sore throat
  •  Westly and Alberta Clinical Practice Guideline Working Group guidelines

Treatment:

  • Most children recover from viral croup by breathing in moist air, and older kids may find it more comfortable to take ibuprofen or acetaminophen (only if they are over 6 months old). Rest and a lot of fluids are advised, as with most diseases.
  • Use a cool-mist humidifier or take a hot shower to fill the bathroom with steam so that parents and children can sit there for 10 minutes to expose children to moist air. A child's violent coughing may occasionally stop if they take a breath of the mist. During the cooler months, taking a youngster outside to get some fresh air can help with symptoms.
  • Teach parents to spend the night with their child in order to keep a careful eye on them.
  • If a baby's rapid breathing and croupy cough are severe and persistent, get medical help.
  • A kid will be examined by medical specialists if the croup seems severe or if there is a possibility of an airway obstruction. Steroids are frequently used by doctors to treat croup in order to reduce airway edema.
  • For severe cases, breathing treatments containing epinephrine (adrenalin) are offered to help reduce airway edema.
  • A child stays in the hospital for a set amount of time under close observation, and if necessary, oxygen may also be given.

Prevention:

  • Frequent hand washing
  • Avoiding contact with people who have respiratory infections

 

 
Things to remember

  • Croup is a condition that causes an inflammation of the upper airways — the voice box (larynx) and windpipe (trachea).

  • It often leads to a barking cough or hoarseness, especially when a child cries.

  • Most cases of croup are caused by viruses, usually parainfluenza virus and sometimes adenovirus or respiratory syncytial virus (RSV).

  • Viral croup is most common — and symptoms are most severe — in children 6 months to 3 years old, but can affect older kids too. Some children are more prone to developing croup when they get a viral upper respiratory infection.

  • Bacterial croup may be divided into laryngeal diphtheria, bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis.
  • Croup is characterized by a "barking" a cough, stridor, hoarseness, and difficulty breathing which usually worsens at night.
  • The "barking" a cough is often described as resembling the call of a seal or sea lion.
  • Oxygen also might be given, and sometimes a child with croup will remain in the hospital overnight for observation.
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Questions and Answers

Inflammation of the voice box (larynx) and windpipe is a symptom of the illness croup (trachea). In particular when a youngster screams, it frequently results in a barking cough or hoarseness. The majority of croup cases are brought on by viruses, typically parainfluenza virus but occasionally adenovirus or respiratory syncytial virus as well.

Viruses are typically thought to be to blame for croup. [1][5] Acute laryngotracheitis, spasmodic croup, laryngeal diphtheria, bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis are all included in the term's broader usage. The symptoms of the first two illnesses, which are caused by viral infections, are typically milder than those of the following four, which are caused by bacterial infections and are typically more severe.

Viral

In 75% of instances, parainfluenza virus (a member of the paramyxovirus family), especially types 1 and 2, is the cause of viral croup or acute laryngotracheitis. [2] Other viral causes include respiratory syncytial virus, measles, influenza A and B, adenovirus, and influenza (RSV). [4] While being caused by the same family of viruses as acute laryngotracheitis, spasmodic croup does not exhibit the typical symptoms of infection. Treatment outcomes and responses are comparable.

Bacterial

Laryngeal diphtheria, bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis are different types of bacterial croup. While bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis are typically caused by a primary viral infection with secondary bacterial growth, laryngeal diphtheria is caused by Corynebacterium diphtheriae. Staphylococcus aureus, Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis are the most often mentioned microorganisms.

Treatment:

  • Viral croup typically has milder cases, but not always. The majority of children find that breathing in the humid air makes them feel better, and ibuprofen or acetaminophen (only in infants over 6 months old) may help them feel more comfortable. Rest and a lot of fluids are advised, as with most diseases.
  • The ideal option to provide your child with moist air is to use a cool-mist humidifier or take a hot shower to fill the room with steam so you can spend 10 minutes there together. A child's violent coughing may occasionally stop if they take a breath of the mist. During the cooler months, taking your child outside to enjoy some fresh air can help with symptoms. You might also try bringing your kid along for a drive with the car windows slightly lowered.
  • To give close supervision, you might think about spending the night in the same room as your child. Call your doctor or get emergency help right away if you can't stop your child's rapid breathing and croupy cough.
  • If it looks that your child has croup or if there is a possibility that the airway is blocked, medical personnel will examine your child. Steroids are frequently used by doctors to treat croup in order to reduce airway edema. Doctors will administer a breathing treatment that contains epinephrine in severe cases. This quickly reduces airway swelling. A child with croup may also receive oxygen, and occasionally they are kept overnight in the hospital for observation.

Prevention:

  • Avoiding contact with those who have respiratory infections
  • Frequently washing your hands

 

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