CHILDREN’S HEALTH: CROUP

Posted by admin on April 28, 2009 under General health | Be the First to Comment

Croup is an inflammation and swelling of the larynx (voice box), usually caused by an infection. Croup is common and is passed on in the same manner as a common cold-by airborne droplets or by direct contact with an infected person.

Croup causes a tight, dry, barking cough and hoarseness. Difficult breathing develops quickly, with more trouble breathing in than breathing out. Efforts to breathe in cause the crowing sound that is typical with croup. (This is the opposite of the breathing difficulty that is seen with asthma. A child with asthma has more difficulty breathing out, and a wheezing sound is heard when the child breathes out.) Croup can be serious, but milder cases, especially repeated ones, can usually be safely handled at home.

There is a form of croup-epiglottitis- that is a life-threatening illness, a true emergency in which minutes count. It is an infection of the epiglottis (covering of the larynx) and surrounding tissues, caused by bacteria. It is most common in children between three and nine years of age. There is a rising fever to 39.4°Ñ and up to 40°C. Difficulty with breathing quickly becomes severe. The child drools and may have trouble swallowing, preferring to sit with the head forward, mouth open, and tongue partially out. The condition rapidly progresses to choking and convulsions; treat immediately.

Signs and symptoms

The key symptoms of croup are a barking cough, hoarseness, difficult breathing, and a crowing sound heard when the child breathes in. There may be no fever or a low-grade fever (38.3°C).

It is important always to consider the possibility of epiglottitis when any of these symptoms are present.

Choking on a foreign object may resemble croup, since both share the same symptom of frantic efforts to breathe. However, it is easy to tell choking from croup by one key sign. A choking child cannot speak or cry out; a child with croup can talk or cry. Fever may be another clue, since a child with croup may have a fever but a choking child does not.

Home care

If a child is having serious difficulty breathing, do not try to care for the child at home. Notify your doctor, and head for the nearest hospital emergency room.

Mild, repeated attacks of croup can often be cared for at home (if there is no serious difficulty breathing). However, it is best to call your doctor the first time you suspect your child has croup.

The basic home care for mild attacks is adding moisture to the air to relieve the cough and help the child breathe more easily.

Use steam from a vaporizer or humidifier. Steam also may be generated quickly and temporarily by running a hot shower in a closed bathroom. Sit in the room with your child for a short while. If the symptoms are not relieved, call your doctor.

Precautions

• If your child has a high fever, difficulty breathing and swallowing, is drooling, or sits with the head forward, mouth open, and tongue hanging out, get medical help immediately.

• Never give any type of cough medicine to a child with croup or any difficulty breathing.

• Do not give ipecac as a home treatment for croup; ipecac may make breathing even more difficult.

Medical treatment

For croup, your doctor’s treatment will be the same as your home treatment. However, the doctor may hospitalize your child and use a croup tent with high humidity. The doctor may also order X rays, cultures, and a blood count. If the condition becomes severe, your child may be intubated (have a tube inserted in the airway).

Epiglottitis is always treated as an emergency. Your child will be intubated. If necessary, the doctor may perform a tracheotomy (opening the windpipe surgically through the neck). Intravenous fluids and antibiotics will be given, and the child’s condition will be carefully watched.

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