From the Research
Croup is characterized by a distinctive barking cough, hoarseness, and stridor, which typically worsen at night, resulting from inflammation and narrowing of the upper airway, usually due to viral infection. These symptoms often begin with cold-like signs before progressing to the characteristic cough, and may be accompanied by fever, runny nose, and difficulty breathing 1. Children with croup may also experience retractions, rapid breathing, fatigue, bluish discoloration around the mouth, and decreased alertness in severe cases. The barking cough occurs because the swollen, inflamed vocal cords and surrounding tissues vibrate abnormally during breathing.
Key Symptoms
- Barking cough
- Hoarseness
- Stridor (a high-pitched whistling sound during breathing)
- Respiratory distress
- Fever
- Runny nose
- Difficulty breathing
According to the most recent and highest quality study, the use of corticosteroids, such as dexamethasone, is highly efficacious in treating croup symptoms 2. The study found that dexamethasone, given orally as a single dose at 0.6 mg/kg, is effective in treating croup symptoms. While other studies have also shown the effectiveness of corticosteroids in treating croup, the most recent study provides the strongest evidence for their use 3, 4.
Management
- Mild cases can be managed at home with cool mist, hydration, and comfort measures
- Severe breathing difficulty, persistent stridor at rest, or signs of respiratory distress require immediate medical attention
- Corticosteroids, such as dexamethasone, are the treatment of choice for mild, moderate, and severe croup 2