From the Guidelines
Yes, adults can develop croup, although it is relatively rare compared to its occurrence in children. The provided evidence does not directly address the question of adults developing croup, as it primarily focuses on pertussis infection and its management 1. However, based on general medical knowledge, croup in adults can be caused by various factors, including viral infections and, less commonly, bacterial infections.
Key Considerations
- Croup in adults may present with symptoms similar to those in children, including a barking cough, hoarseness, and stridor, but the severity and management can differ due to anatomical and physiological differences.
- The diagnosis of croup in adults is often clinical, based on the presentation of symptoms, and may involve ruling out other causes of respiratory distress.
- Treatment for croup in adults typically involves supportive care, such as rest, hydration, and the use of humidifiers to relieve symptoms, similar to the approach in pediatric cases.
Management and Treatment
- Corticosteroids, like dexamethasone, are commonly used to reduce inflammation in the airway, and their use is supported by evidence in pediatric populations, though the specific application in adults may vary based on the severity of symptoms and underlying health conditions.
- In severe cases, where there is significant airway obstruction, more intensive interventions, such as nebulized epinephrine, may be considered, especially if the patient shows signs of respiratory distress or failure.
Important Considerations for Adults
- Adults with underlying respiratory conditions, such as asthma or COPD, may experience more severe symptoms or complications from croup, necessitating closer monitoring and potentially more aggressive management.
- The presence of difficulty breathing, persistent stridor at rest, or an inability to swallow are indicators for seeking immediate medical attention, as these can be signs of severe airway obstruction, which is a medical emergency.
Given the lack of direct evidence from the provided study 1 on croup in adults, the approach to diagnosis and management is based on general principles of respiratory medicine and the extrapolation of evidence from pediatric populations, where applicable. It is crucial for adults experiencing symptoms of croup to seek medical evaluation to determine the best course of treatment and to rule out other potentially serious conditions.
From the Research
Adult Croup Diagnosis and Management
- Croup, or laryngotracheitis, is rare in adults, but it can occur, as seen in a case study of a young woman who presented with symptoms of croup, including a barking cough, paradoxical abdominal breathing, and stridor 2.
- Adult croup is considered a more severe condition than pediatric croup, with 91% of patients requiring intensive care support, according to a study that reviewed 10 cases of adult croup 3.
- The diagnosis of croup in adults is similar to that in children, with symptoms including a barking cough, hoarse voice, stridor, and respiratory distress, although laboratory studies and radiography are not always necessary for diagnosis 4.
Treatment and Management
- Treatment for adult croup typically involves the use of corticosteroids, such as dexamethasone, which has been shown to be effective in reducing symptoms and improving outcomes in both children and adults with croup 2, 5.
- Nebulized epinephrine and helium-oxygen mixtures may also be used to help manage symptoms, particularly in severe cases 2.
- While there is limited research on the use of prophylactic inhaled corticosteroids for recurrent croup in adults, a study on children suggests that this approach may be effective in reducing the frequency of recurrent croup episodes 6.
Key Findings
- Adult croup is a rare but potentially severe condition that requires prompt diagnosis and treatment.
- Corticosteroids, such as dexamethasone, are a key component of treatment for adult croup.
- Further research is needed to fully understand the diagnosis, management, and treatment of adult croup, particularly with regards to the use of prophylactic inhaled corticosteroids.