Generality
Croup is a respiratory disease that affects young children, causing a very peculiar cough, hoarse voice and breathing problems.
Figure: a barking cough, that is, similar to a dog's barking, is the characteristic symptom of the croup. From the site: patient.co.uk
In most cases, the croup is due to a "viral infection, although it can also arise for completely different causes.
The diagnosis is quite simple and is based on an "analysis of the symptoms, the severity of which also depends on the therapeutic choices; if the symptoms are particularly severe, the little patient may need specific treatments or even be hospitalized.
What is the croup?
Croup, or laryngotracheobronchitis, is an airway disease typical of young children, causing shortness of breath and a very characteristic "barking" cough.
WHICH RESPIRATORY TRACT ARE YOU INTERESTED?
The croup causes an enlargement of the larynx, that is the last tract of the upper airways; moreover, it obstructs the trachea and the pulmonary bronchi, which represent the first tracts of the lower airways.
EPIDEMILOGY
Figure: the sections of the respiratory tract affected by the inflammatory process in red. From the site: babyreflux.co.uk
The croup usually affects children between the ages of 6 months and 3 years.
However, it is not entirely excluded that it can also affect younger children and adolescents.
In adults, its occurrence is very rare.
Although the croup can appear in any season of the year, it is more common in the late fall and early winter.
Among males and females, male children suffer the most.
The same person can contract the croup several times during his childhood.
Causes
The croup is usually the result of a "viral infection."
The potentially responsible viruses are:
- Human paraninfluenza viruses. They are the main architects of the croup; of the 4 existing species (I, II, III and IV), species I is the most dangerous (as far as the croup is concerned, of course).
- The influenza A and B viruses
- The measles virus
- The Rhinovirus
- Enteroviruses
- The human respiratory syncytial virus.
TRANSMISSION OF PARAINFLUENZAL VIRUSES
Human parainfluenza viruses can spread after direct contact between a healthy person and an infected person, or after contact with contaminated objects.
A common method of diffusion by direct contact is represented by the "inhalation of droplets containing the virus and present in the air as a result of sneezing or coughing, made by infected individuals.
OTHER CAUSES
The croup can also have a "non-infectious origin; although very rarely, in fact, it can arise from:
- Inhaling small objects, such as peanuts, peas, etc.
- An "epiglottitis, or" inflammation of the "epiglottis.
- An allergic reaction to pollen or dust mites
- Inhalation of irritants
- Gastroesophageal reflux
Symptoms and Complications
For further information: Croup Symptoms
Typical croup symptoms are:
- "Barking" cough. It is said in this way due to the similarity with the barking emitted by the dog.
- Hoarse voice.
- Respiratory difficulties. They are greater in younger children, as they have rather narrow airways and a slight swelling of the larynx is enough to block them.
- Emission, during the breath, of a sound similar to something screeching: more simply screeching.
- Typical cold expressions, in other words: nose that there, sore throat and fever.
Symptoms, particularly stridor, may worsen overnight or when the baby is crying, agitated and / or coughing.
Typically, the croup demonstrations last 3 or 4 days, then fade away.
WHEN DOES THE CROUP HAVE TO WORRY?
Croup is generally not a dangerous disease.
When it becomes so, however, it is characterized by the appearance of one or more of the following symptoms and signs:
- Severe breathing problems
- Increase in the number of breaths o Chest silent
- Agitation
- Worsening of the stridor
- Cyanosis in the fingers or paleness
- Abnormal sleepiness
- High fever
- Inability or refusal to take fluids
- Tachycardia or bradycardia
- Ribs and chest very noticeable
The presence of one or more of these manifestations must prompt parents to contact the pediatrician immediately or to go to the nearest hospital center, for an in-depth analysis of the situation and to receive any treatment.
According to some Anglo-Saxon studies, less than 5% of croup cases involve problems that make it necessary to hospitalize the sick child.
COMPLICATIONS IN CASE OF NON-TREATMENT
Although rarely, failure to treat the croup can lead to complete airway obstruction (possibly respiratory arrest), secondary infections (eg pneumonia, tracheitis, or laryngeal diphtheria), ear infections or lymphadenitis.
Insight into secondary infections: which bacteria are involved?
It is possible that the "viral infection is followed by a" bacterial infection (in medicine, this evolution is called bacterial overlap).
The bacteria potentially able to associate with the virus responsible for the croup are:
- Corynebacterium diphtheriae
- Staphylococcus aureus
- Streptococcus pneumoniae
- Haemophilus influenzae
- Moraxella catarrhalis
Diagnosis
To establish the diagnosis of croup, it is sufficient for the doctor to observe the symptoms and note the presence of some typical signs caused by the disease, such as "barking" cough, stridor while breathing, etc.
If, for some reason, after careful observation of the symptoms there are doubts, more in-depth checks can be performed, such as chest X-ray examination or blood tests.
Treatment
Treatment of the croup depends on the severity of the symptoms.
Usually, the infection can be treated at home with simple remedies and with the administration of some anti-inflammatories, such as paracetamol or ibuprofen for children.
The use of more potent drugs (corticosteroids) and hospitalization are indicated for medium-severe and very severe cases, respectively.
SOME RECOMMENDED REMEDIES
To speed up healing and soothe the baby, it is recommended that you:
- To maintain hydrated the little patient, giving him enough fluids. The risk of dehydration when illnesses such as croup, cold, flu etc. are present is high.
- Have the sick child sit in a position that is comfortable for breathing.
- Reassure the patient, perhaps distracting him with some games, because crying and agitation worsen the symptoms.
IN CASE OF SEVERE CROUP
In the case of a severe croup, the doctor may administer adrenaline by aerosol and oxygen via a mask (oxygen therapy).
Hospitalization is used when the child needs to be intubated in order to breathe. Intubation should be performed under general anesthesia.
Prevention
Taking care of the baby's hygiene, not exposing him to contact with people with colds or flu, and vaccinating him against viral infections (also according to the doctor's opinion), are three excellent ways to prevent croup.
