Croup
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| Croup Classification and external resources | |
| ICD-10 | J05.0 |
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| ICD-9 | 464.4 |
| DiseasesDB | 13233 |
| MedlinePlus | 000959 |
| eMedicine | ped/510 emerg/370 radio/199 |
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Ongoing Trials on Croup at Clinical Trials.gov Clinical Trials on Croup at Google
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Croup (sometimes referred to as croup syndrome or laryngotracheobronchitis) is a respiratory disease which afflicts infants and young children, typically aged between 3 months and 3 years. The respiratory symptoms are caused by inflammation of the larynx and upper airway, with resultant narrowing of the airway.
Signs and symptoms
Croup is characterized by a harsh 'barking' cough, inspiratory stridor (a high-pitched sound heard on inhalation), nausea/vomiting, and fever. Hoarseness is usually present. More severe cases will have respiratory distress.
The 'barking' cough (often described as a "seal like bark")[1] of croup is diagnostic. Stridor will be provoked or worsened by agitation or crying. If stridor is also heard when the child is calm, critical narrowing of the airway may be imminent.
In diagnosing croup, it is important for the physician to consider and exclude other causes of shortness of breath and stridor, such as foreign body aspiration and epiglottitis.
On a frontal X-ray of the C-spine, the steeple sign suggests the diagnosis of croup.
Causes
Croup is most often caused by parainfluenza virus, primarily types 1 and 3, but other viral and possibly bacterial infections can also cause it. It is most common in the fall and winter but can occur year-round, with a slight predilection for males.
The respiratory distress is caused by the inflammatory response to the infection, rather than by the infection itself. It usually occurs in young children as their airways are smaller and differently shaped than adults', making them more susceptible. There is some element of genetic predisposition as children in some families are more susceptible than others.
An entity known as spasmodic croup also occurs, distinct from the infectious variety, due to laryngeal spasms.
Treatment
The treatment of croup depends on the severity of symptoms.
One of the simplest ways to treat croup is to inhale hot steam. This was the sole treatment for croup throughout the nineteenth and most of the twentieth century. Hospitals today use a "blowby" apparatus for this purpose. Simpler remedies include taking the child outside in moist night air, or alternatively exposing the child to steam from a hot bath or a humidifier. These techniques may help in some cases, but there is little hard evidence to support their efficacy.
Mild croup with no stridor, or stridor only on agitation, and just a cough may simply be observed, or a dose of inhaled, oral, or injected steroids may be given. When steroids are given, dexamethasone is often used, due to its prolonged physiologic effects.
Moderate to severe croup may require nebulized adrenaline in addition to steroids. Oxygen may be needed if hypoxia develops. Children with moderate or severe croup are typically hospitalized for observation, usually for less than a day. Intubation is rarely needed (less than 1% of hospitalized patients).
Prognosis
Viral croup is a self-limited disease, but can very rarely result in death from complete airway obstruction. Symptoms may last up to 7 days, but typically peak around the second day of illness. Rarely, croup can be complicated by (or confused with) an acute bacterial tracheitis, which is more dangerous.
References
External links
- MayoClinic
- Ask Dr. Sears
- Four kinds of croup http://www.healthscout.com/ency/68/135/main.html
WikiDoc Research Resources for Croup | |
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| Articles on Croup | Most recent articles on Croup • Most cited articles on Croup • Review articles on Croup • Articles on Croup in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Croup | Powerpoint slides on Croup • Images of Croup • Photos of Croup • Podcasts & MP3s on Croup • Videos on Croup |
| Evidence Based Medicine Regarding Croup | Cochrane Collaboration on Croup • Bandolier on Croup • TRIP on Croup |
| Cost Effectiveness of Croup | Cost Effectiveness of Croup |
| Clinical Trials Involving Croup | Ongoing Trials on Croup at Clinical Trials.gov • Trial results on Croup • Clinical Trials on Croup at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Croup | US National Guidelines Clearinghouse on Croup • NICE Guidance on Croup • NHS PRODIGY Guidance • FDA on Croup • CDC on Croup |
| Textbook Information on Croup | Books and Textbook Information on Croup |
| Pharmacology Resources on Croup | Dosing of Croup • Drug interactions with Croup • Side effects of Croup • Allergic reactions to Croup • Overdose information on Croup • Carcinogenicity information on Croup • Croup in pregnancy • Pharmacokinetics of Croup • |
| Genetics, Pharmacogenomics, and Proteinomics of Croup | Genetics of Croup • Pharmacogenomics of Croup • Proteomics of Croup |
| Newstories on Croup | Croup in the news • Be alerted to news on Croup • News trends on Croup |
| Commentary on Croup | Blogs on Croup |
| Patient Resources on Croup | Patient resources on Croup • Discussion groups on Croup • Patient Handouts on Croup • Directions to Hospitals Treating Croup • Risk calculators and risk factors for Croup |
| Healthcare Provider Resources on Croup | Symptoms of Croup • Causes & Risk Factors for Croup • Diagnostic studies for Croup • Treatment of Croup |
| Continuing Medical Education (CME) Programs on Croup | CME Programs on Croup |
| International Resources on Croup | Croup en Espanol • Croup en Francais |
| Business Resources on Croup | Croup in the Marketplace • Patents on Croup |
| Informatics Resources on Croup | List of terms related to Croup |
de:Pseudokruppit:Croup nl:Pseudokroep ja:クループ no:Falsk krupp nn:Falsk krupp
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
