Common childhood illness usually caused by inflammation of the upper respiratory tract (predominantly the larynx and trachea but it may affect the bronchi) as a result of viral infection
Aetiology
Most commonly caused by parainfluenza virus I, can also becaused by parainfluenza virus types II, III, IV, RSV, adenovirus and others
Most common in second year of life
Pathophysiology
Viral upper respiratory tract infection (URTI) causes nasopharyngeal inflammation that may spread to the larynx and trachea, causing subglottal inflammation, oedema and compromise of the airway at its narrowest portion
The movement of the vocal cords is impaired leading to the characteristic cough
Clinical presentation
Normally starts with nonspecific symptoms of viral URTI - runny nose, sore throat, fever and cough
This progresses over the course of a couple of days to include the characteristic barking cough, hoarseness and stridor; these symptoms tend to be worse at night
Management
Most children will have mild croup, which can be managed at home
Moderate or severe croup requires hospital management - dexamethasone and supportive care e.g. O2
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