Croup is a respiratory disease in children which is generally caused by a viral infection. Children who suffer from croup usually experience typical symptoms , namely a loud cough like barking.

Infection in this condition causes swelling of the upper respiratory tract, ranging from the larynx (the respiratory tract after the oral cavity), the trachea (windpipe), to the bronchi (the branches of the trachea leading to the lungs).


This swelling makes the airways narrow and causes the characteristic croup symptoms. Croup can be contagious, especially in the first few days after your child has croup, or while your child has a fever.

Causes of Croup

Based on the cause, croup can be divided into two types, namely:

Viral croup

Viral croup is the most common type of croup. Generally, this type of croup is caused by the parainfluenza virus. However, there are several types of viruses that can also cause viral croup, namely adenovirus , respiratory syncytial virus (RSV), and measles virus.

Viral croup can be transmitted through droplets when an infected person coughs or sneezes. The virus that causes croup can also stick to objects that have been splashed with the saliva of an infected person.

Children can become infected with croup if they touch their mouth, eyes or nose without washing their hands after touching the contaminated item.

Spasmodic croup

Spasmodic croup is a type of croup caused by allergies or stomach acid that rises into the esophagus and respiratory tract.

Spasmodic croup occurs suddenly and usually appears in the middle of the night. The child may wake up with shortness of breath, but no fever . This type of croup also has a risk of recurrence.

Although very rare, croup can also be caused by a bacterial infection or chemicals that irritate the respiratory tract. Croup due to this bacterial infection can cause more severe symptoms than croup due to a viral infection .

Croup risk factors

Croup occurs in children, especially children in the age range of 3 months to 5 years. In addition, boys also tend to get croup more often than girls.

Symptoms of Croup

Symptoms of croup usually last for 3-5 days. The following are symptoms that commonly appear in children with croup:

  • Loud cough like barking, usually worse at night
  • Stridor (rough breath sounds)
  • Hoarseness
  • Hard to breathe

Other symptoms can also appear depending on the type of croup experienced. The explanation is as follows:

Viral croup

Other symptoms that often appear in children with viral croup are fever and runny nose . Viral croup is generally mild and does not cause serious breathing problems, such as shortness of breath. However, symptoms can be more severe if not treated immediately.

Spasmodic croup

Children who have spasmodic croup can look fine. However, at midnight there will be symptoms of hoarseness and rough breath sounds. These symptoms usually improve within a few hours if the child is brought to an open area with fresh air, but they can appear for several nights in a row.

When to see a doctor

Check with your doctor if your child has any of the above symptoms, especially if the symptoms get worse, are accompanied by a high fever, or don't get better in 2 days. Early examination is needed to prevent the condition from getting worse.

In some cases, croup can cause severe swelling of the airways, causing severe shortness of breath. This condition can be dangerous for children. Therefore, immediately take the child to the emergency room if the following symptoms appear:

  • High-pitched sounds such as whistling when inhaling or exhaling
  • Difficulty swallowing
  • Excessive salivation
  • More agitated or fussy
  • Look tired or sleepy
  • The skin around the mouth, nose, and nails looks blue

Diagnosis Croup

To diagnose croup, initially the doctor will ask what symptoms are experienced and whether the child has had direct contact with someone who has had a cough or runny nose in the last few days.

After that, the doctor will observe the child's breathing, examine the throat, and listen to the sound of breathing in the chest using a stethoscope.

If the symptoms of croup are severe and unusual, the doctor will perform an X-ray examination to detect the possibility of a more serious respiratory tract disease.

Croup Treatment

Treatment for croup is done to treat infection, relieve symptoms, and prevent disease transmission. The treatment given will be adjusted according to the severity of the symptoms.

The following are several ways to treat croup:

Self care at home

Croup that causes only mild symptoms can be treated with self-care at home. Self-care that can be done include:

  • Make sure the child always feels comfortable and calm, because crying can exacerbate the condition of the respiratory tract
  • Positioning the child in an upright sitting position on the lap or in a toddler chair, so that it is easier for the child to breathe
  • Fulfill fluid intake by giving breast milk, for children who are still breastfeeding, or water, soup, and fruit , for older children
  • Ensuring children get more rest
  • Don't give over-the-counter cough and cold medicine, because it won't help cure croup
  • Provide a humidifier and ensure the child's room has fresh and clean air
  • Free the house from cigarette smoke and flying dust
  • Rest or sleep near the child so that his condition is always monitored and can take action quickly if the symptoms worsen
  • Give fever-reducing drugs, such as paracetamol , if the child has a fever

Treatment by doctor

If croup symptoms get worse or don't improve within 2 days, see a doctor. To handle it, the doctor will prescribe a corticosteroid class of drugs, such as dexamethasone , to relieve swelling in the respiratory tract. If croup is suspected to be caused by a bacterial infection, the doctor will give antibiotics .

If there is shortness of breath, the child may be given additional medication through a nebulizer to make his breathing easier. Doctors may also consider hospitalization if your child's symptoms are severe and need frequent monitoring. While in the hospital, always accompany the child and make sure the child remains comfortable and calm.

Croup complications

Although rare, croup can cause complications such as:

  • Severe shortness of breath, characterized by the child needing to make extra efforts to catch their breath, such as lifting the chest, raising the chin, and the abdominal wall looks like it is being pulled in
  • Respiratory failure
  • A new infection that appears (secondary infection), such as pneumonia or bacterial tracheitis
  • Middle ear infection
  • Lymphadenitis

Croup Prevention

Generally, croup is caused by a virus that causes influenza , so the steps to prevent it are the same as preventing influenza, namely:

  • Wash your hands regularly with soap and running water
  • Teach children to always wash their hands before and after touching their mouth, nose or eyes
  • Keeping children away from people who are sick
  • Teach children to cover their mouths when sneezing or coughing

Some severe cases of croup can also be caused by the measles virus . To prevent this, children can be given the measles vaccine .

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