Symptoms

Croup is marked by a distinctive seal-like barking cough, hoarseness, and difficult breathing. Croup lasts 3 to 5 days and may be accompanied by a cold or fever.

Croup without fever (spasmodic croup) comes on suddenly during the night. The child may have seemed perfectly healthy during the day or had a mild cold, but suddenly wakes up with a violent fit of croupy coughing.

Croup with fever (laryngotracheobronchitis) is a more serious form of croup that inflames the area around the vocal cords down to the large bronchi. It is usually accompanied by a chest cold. The child’s temperature usually is above normal but lower than 102°F. The croupy cough and tight breathing usually develop slowly and are often worse at night. If your child does not respond promptly to simple home measures, see your doctor.

Epiglottitis is a bacterial infection of the respiratory tract that sometimes seems like severe croup with a fever. The child’s temperature is usually higher than 102°F. The child drools and gasps for air, does not respond to the simple measures that bring relief of croup, and must receive immediate medical attention. Epiglottitis usually starts very quickly, which distinguishes it from croup. Thanks to the Haemophilus influenza type B (Hib) vaccine, epiglottitis is now very rare.

Self-Care

Most children with croup can be cared for at home. Three key elements in treatment are providing moist air, keeping the child sitting up or propped up, and encouraging the child to drink plenty of fluids.

• Cough medicines and antibiotics are not effective in treating croup.
• Add moisture to the air to make it easier to breathe. The simplest method to do this is to take the child into the bathroom, close the door, and turn on the hot water faucet of the shower. Sit with the child upright on your lap on the bathroom floor for 15 to 20 minutes, inhaling steam. Other options are a brief walk outdoors or a cold-mist humidifier in the child’s bedroom.
• Avoid exposure to smoke from cigarettes, fireplaces, or wood-burning stoves.
• Give plenty of clear fluids, such as water or diluted juice, to prevent dehydration and help loosen the cough.
• Use a nonaspirin pain reliever (acetaminophen) to reduce fever and discomfort. Do not give a child aspirin, because use of this medication
  in children and teenagers has been linked to a rare but serious condition known as Reye’s syndrome.
• Elevate the head of your child’s bed.
• A child with croup is often frightened and crying, so try to reassure your child with a hug or distract him or her with a book or favorite game.
• Call your doctor if your child has croup symptoms for more than three nights.