Aka laryngotracheobronchitis
Common upper respiratory tract infection accompanied with a distinct 'seal like' barking cough and occasionally with stridor, hoarse voice and respiratory distress.
The symptoms are a result of upper respiratory tract inflammation resulting in narrowing of the upper respiratory airways.
Most commonly occur in those between 6months-6years, male, symptoms usually worse at night
Croup can be mild (barking cough without any increased work of breathing), moderate (barking cough with stridor and
moderated increased work of breathing), severe (barking cough with severly increased work of breathing, lethargy /agitation).
Mild/Mod croup can be managed with corticosteroids (dexamethasone, prednisone) and nebulised adrenaline. Nebulised adrenaline is often given in moderate croup, its effects will last for ~2hrs. Patients may be discharged home after a period of observation.
In severe croup the above are required along with supplement oxygen. If the patient does not improve or there is risk of respiratory failure - intubation is considered.
Diagnosis is clinical. However on chest x-ray the steeple sign (narrowed trachea) is a classical finding on AP view
However other diagnoses to consider are: epiglottitis, bacterial tacheitis, foreign body inhalation, peritonsillar abscess, congenital tracheo/bronchomalaecia.
