Croup, also called laryngotracheobronchitis, is a viral illness that typically affects younger children, most commonly between ages six months and three years. The usual presentation is a cough that sounds very much like a barking dog. In croup, the airway just below the vocal cords is narrowed, and this narrowed anatomy gives the cough its distinctive sound. Some children with croup make a noise on inspiration that resembles a honk or a sound a seal makes; this is termed stridor. Croup may appear suddenly at night and a child may appear very ill.
If your child has croup, the symptoms can often be relieved by taking him into the bathroom, turning the shower on, closing the door, and having him sit in an upright position while inhaling the steam. It may take 10 to 20 minutes for improvement to occur. Just moving from the lying to the upright position may help, and elevating the head of the bed or crib when he goes back to bed may be beneficial. Cool mist in the room may be helpful. Going out into cool night air may also relieve the acute symptoms. Sometimes treatment in an emergency room is necessary if these measures do not help quickly. Croup is usually worse at night; the next day a child may appear fine except for a cold. Your doctor may need to see your child. A steroid medication, dexamethasone, can help this condition and may prevent a recurrence the next night.
Other conditions can be confused with croup. An attack of asthma can cause respiratory distress. An asthmatic child will wheeze, making whistling sounds on exhalation. Aspiration of a foreign body must be suspected in any child with respiratory difficulty. Acute epiglottitis can cause fever, respiratory difficulty, and inability to swallow with drooling. If your child has obvious respiratory distress, lethargy, or a blue color you must seek medical attention immediately.