Croup is an illness of the upper airway that commonly affects infants and young children, producing a characteristic barking cough, noisy breathing and hoarseness. It is most often caused by viral infections. The information below offers general guidance and describes when primary or specialist assessment may be warranted.
Croup occurs when the upper airway (around the larynx and upper trachea) becomes inflamed and narrowed. It is most common between about 6 months and 3 years of age, but older children can be affected. Various respiratory viruses—parainfluenza being a frequent trigger—can cause croup; severity ranges from mild cough to more marked breathing difficulty.
The hallmark sign is a loud, barking cough that often worsens at night. Other features can include stridor (a high-pitched noise when breathing in), hoarseness and low-grade fever. Symptoms typically improve over several days, though how quickly they resolve varies by child. Parents commonly notice symptom peaks in the evening or night.
Seek urgent evaluation if a child has persistent or worsening breathing difficulty at rest, loud or worsening stridor while calm, blue or pale lips or skin, trouble feeding or reduced alertness, or extreme agitation. These signs require immediate medical attention. For less severe symptoms, contact your child’s primary care or pediatric provider for advice.
Diagnosis is usually based on history and physical exam; routine tests are not always needed. Mild cases can be managed by family doctors or pediatricians with close follow-up. Refer to Pediatrics or Ear, Nose and Throat (ENT) specialists when breathing is significantly impaired, attacks recur, or the diagnosis is uncertain; hospital assessment may be required for more serious cases.
Reduce infection risk with good hand hygiene and by avoiding close contact with sick individuals. Keep the child well hydrated and avoid exposing them to cigarette smoke. Humidified air or calm, comforting measures may relieve symptoms at home, but any worsening or warning signs should prompt professional assessment rather than watchful waiting.
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