Croup

Upper respiratory tract infection causing oedema in the larynx

Aetiology

• Viral
• Classically parainfluenza virus
• Other common causes include influenza, adenovirus and Respiratory Syncytial Virus (RSV)
• Used to be caused by diptheria but this is now very rare in developed countries due to vaccination

Clinical presentation

• Increased work of breathing

• 'Barking' cough, occurring in clusters of coughing episodes

• Hoarse voice

• Stridor

• Low grade fever

Investigations

• Usually clinical diagnosis

Management

• Mild croup is largely self-limiting, but treatment with a single dose of a corticosteroid (e.g. dexamethasone) by mouth may be of benefit

• In moderate-severe croup requiring hospital admission:
1. Oral dexamethasone - if too unwell to receive oral medication can give IM dexamethasone or nebulised budesonide
2. Oxygen
3. Nebulised adrenaline
4. Intubation and ventilation