Croup (Acute Laryngotracheobronchitis)

Viral Infection That Cause Acute Laryngeal and Subglottic Swelling in Children

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Croup (Acute Laryngotracheobronchitis) is an infection that affects the larynx and trachea, usually caused by the Parainfluenza Type I virus. Among the main bacterial causes are bacteria such as Corynebacterium diphtheriae and Staphylococcus aureus, Streptococcus pneumoniae, Hemophilus influenzae and Moraxella catarrhalis, which can cause other respiratory infections.

Symptoms of Croup

- Barking cough
- Sound when breathing (stridor)
- Hoarseness

These symptoms may increase at night. It usually occurs in children between the ages of 6 months and 6 years. It is not seen in adolescents and adults.

These symptoms are due to swelling in the inner mucosa of the larynx and trachea and narrowing of the airways.

"The Westley Score" scoring system is available for the Croup. This classification system is made according to the symptoms and the severity of airway obstruction. You can find detailed information about this scoring system on the link >>

Acute Laryngotracheobronchitis, Croup, Barking Cough, Stridor, Acute Laryngeal and Subglottic Swelling, Hoarseness

Diagnosis of Croup

Croup is diagnosed with these symptoms and examination.

Croup is a clinical diagnosis. The first thing to do in a patient presenting with these symptoms is to exclude epiglottitis and other obstructive conditions of the upper respiratory tract (foreign body in the airway, subglottic stenosis, angioedema, retropharyngeal abscess and bacterial tracheitis).

The frequency of croup has decreased due to flu and diphtheria vaccination.

Treatment of Croup

Croup treatment is done as follows:

Children with croup are usually kept as calm as possible.

- Cold steam application was emphasized as the gold standard treatment method in ancient sources; However, new publications brought different interpretations about the necessity of cold steam application. Many croup cases improve with cold steam application and steroid application.

- Steroids used in severe cases are given with epinephrine

Children with oxygen saturation below 92% need oxygen, and those with severe symptoms of croup should be hospitalized for observation.

- If oxygen is required, the use of a mask is recommended to keep an oxygen source close to the child's face to cause less agitation.

Very rarely (0.2% of patients endotracheal intubation) is required.

Sounds of Croup (Laryngotracheitis) - Lung Sounds Video

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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