Croup is a very common respiratory condition usually in children affecting the trachea (windpipe), airways to the lungs (bronchi) and the voice box (larynx) to swallow and become narrow. It is caused by a viral infection or allergic reaction.
Croup generally affects the children aged from 6 months 3 years old, but older children may also get affected.
A child with croup will have a cough that sounds like a barking dog or a barking seal, a high-pitched noise of a seal or a dog. The voice will also sound raspy and hoarse especially when a child cries.
Various names are given to this characteristic sound of croup cough such as a seal sounding cough, a seal like barking cough, a harsh barking cough etc.
The symptoms of croup, generally gets aggravated at night. The child becomes agitated and starts crying, with the following signs:
The squeaky, harsh, vibratory, and rasping noise that is produced in kids when breathing in is called stridor. Stridor occurs when the opening between the vocal cords becomes narrower resulting in turbulent airflow in the respiratory passages. It is more obvious with crying or coughing initially, but can occur during sleep and at rest when the illness worsens subsequently.
A mild illness of croup occurs when your child has the harsh, barking cough but does not have noisy breathing (called stridor) at rest or is not struggling to breathe. Mild croup can be managed at home generally.
Stridor is symptomatic of underlying pathology and may cause life-threatening airway obstruction later if left untreated.
Viral croup (laryngotracheobronchitis) is responsible for more than 80% of cases of acute stridor in kids. It is usually due to the infection with parainfluenza viruses, but it may also be caused by influenza viruses type A or B, respiratory syncytial virus or rhinovirus.
According to a research paper, it commonly affects children aged 6 months to 3 yr with a peak incidence at 2 yr. Only 2% of cases are admitted to hospital every year.
The table below provides croup scores and variations in the croup sound.
|Breath sounds||Normal||Harsh, wheeze||Delayed|
|Stridor||None||Inspiratory||Inspiratory and expiratory|
|Recession/flaring||None||Flaring, suprasternal recession||Flaring, suprasternal and intercostal recession|
|Cyanosis||None||In air||In oxygen 40%|
Source: Research paper titled “Acute stridor in children” and published in BJA
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