Editing Croup (section)

{{Short description|Respiratory infection often caused by a virus}}
{{About|the respiratory condition|the part of a quadruped|rump (animal)|the crop of a bird|crop (anatomy)|the type of casino employee|croupier}}
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{{Good article}}
{{Use dmy dates|date=January 2025}}
{{Infobox medical condition
| name            = Croup
| synonyms        = Croupy cough, subglottic laryngitis, obstructive laryngitis, laryngotracheobronchitis
| pronounce       = {{IPAc-en|k|r|uː|p}}<ref>{{cite web |title=Croup |url=https://www.macmillandictionary.com/pronunciation/british/croup |website=Macmillan |access-date=1 April 2020}}</ref>
| image           = Croup steeple sign.jpg
| caption         = The [[steeple sign]] as seen on an AP neck X-ray of a child with croup
| field           = [[Pediatrics]]
| symptoms        = "Barky" cough, [[stridor]], fever, stuffy nose<ref name=Au10/>
| complications   = 
| duration        = Usually 1–2 days but can last up to 7 days<ref name=Croup09/>
| causes          = Mostly viral<ref name=Au10/>
| diagnosis       = Based on symptoms<ref name=PedN09/>
| differential    = [[Epiglottitis]], airway [[foreign body]], [[bacterial tracheitis]]<ref name=PedN09/><ref name=Cherry08/>
| prevention      = [[influenza vaccine|Influenza]] and [[diphtheria vaccine|diphtheria]] vaccination<ref name=Cherry08/>
| medication      = [[corticosteroids|Steroids]], [[epinephrine]]<ref name=PedN09/><ref name=Cherry08/>
| frequency       = 15% of children at some point<ref name=PedN09/><ref name=Cherry08/>
| deaths          = Rare<ref name=Au10/>
}}

<!-- Definition and symptoms -->
'''Croup''' ({{IPAc-en|k|ɹ|uː|p|}} {{respell|KROOP}}), also known as '''croupy cough''', is a type of [[respiratory infection]] that is usually caused by a [[virus]].<ref name=Au10/> The infection leads to swelling inside the [[trachea]], which interferes with normal breathing and produces the classic symptoms of "barking/brassy" cough, inspiratory [[stridor]], and a [[hoarseness|hoarse voice]].<ref name=Au10/> Fever and [[runny nose]] may also be present.<ref name=Au10>{{cite journal |vauthors=Rajapaksa S, Starr M | title = Croup – assessment and management | journal = Aust Fam Physician | volume = 39 | issue = 5 | pages = 280–2 |date=May 2010 | pmid = 20485713 }}</ref> These symptoms may be mild, moderate, or severe.<ref name=Croup09>{{cite journal | author = Johnson D | title = Croup | journal = BMJ Clin Evid | volume = 2009 | year = 2009 | pmid = 19445760 | pmc = 2907784 }}</ref> It often starts or is worse at night and normally lasts one to two days.<ref name=Thom2013>{{cite journal|last=Thompson|first=M|author2=Vodicka, TA |author3=Blair, PS |author4=Buckley, DI |author5=Heneghan, C |author6=Hay, AD |author7= TARGET Programme, Team |title=Duration of symptoms of respiratory tract infections in children: systematic review.|journal=BMJ (Clinical Research Ed.)|date=11 December 2013|volume=347|pages=f7027|pmid=24335668|doi=10.1136/bmj.f7027 |pmc=3898587}}</ref><ref name=Au10/><ref name=Croup09/>

<!-- Cause and diagnosis -->
Croup can be caused by a number of viruses including [[parainfluenza]] and [[influenza virus]].<ref name=Au10/> Rarely is it due to a [[bacterial infection]].<ref name=Cherry08>{{cite journal | author = Cherry JD | title = Clinical practice. Croup | journal = N. Engl. J. Med. | volume = 358 | issue = 4 | pages = 384–91 | year = 2008 | pmid = 18216359 | doi = 10.1056/NEJMcp072022 }}</ref> Croup is typically diagnosed based on signs and symptoms after potentially more severe causes, such as [[epiglottitis]] or an [[airway foreign body]], have been ruled out.<ref name=PedN09/> Further investigations, such as blood tests, [[X-rays]] and cultures, are usually not needed.<ref name=PedN09>{{cite journal | author = Everard ML | title = Acute bronchiolitis and croup | journal = Pediatr. Clin. North Am. | volume = 56 | issue = 1 | pages = 119–33, x–xi |date=February 2009 | pmid = 19135584 | doi = 10.1016/j.pcl.2008.10.007 }}</ref>

<!-- Prevention and treatment -->
Many cases of croup are preventable by [[immunization]] for [[influenza]] and [[diphtheria]].<ref name=Cherry08/> Most cases of croup are mild and the patient can be treated at home with supportive care. Croup is usually treated with a single dose of [[steroids]] by mouth.<ref name=Au10/><ref name="Gate2018">{{cite journal |vauthors=Aregbesola A, Tam CM, Kothari A, Le ML, Ragheb M, Klassen TP |date=10 January 2023 |title=Glucocorticoids for croup in children. |journal=The Cochrane Database of Systematic Reviews |volume= 2023|issue= 1|pages= CD001955|doi=10.1002/14651858.CD001955.pub5 |pmid=36626194|pmc=9831289 }}</ref> In more severe cases inhaled [[epinephrine]] may also be used.<ref name=Au10/><ref>{{cite journal|last1=Bjornson|first1=C|last2=Russell|first2=K|last3=Vandermeer|first3=B|last4=Klassen|first4=TP|last5=Johnson|first5=DW|title=Nebulized epinephrine for croup in children.|journal=The Cochrane Database of Systematic Reviews|date=10 October 2013|volume=10|issue=10|pages=CD006619|pmid=24114291|doi=10.1002/14651858.CD006619.pub3|pmc=11800190}}</ref> Hospitalization is required in one to five percent of cases.<ref name=CMAJ2013>{{cite journal|last1=Bjornson|first1=CL|last2=Johnson|first2=DW|title=Croup in children.|journal=CMAJ: Canadian Medical Association Journal |date=15 October 2013|volume=185|issue=15|pages=1317–23|pmid=23939212|doi=10.1503/cmaj.121645|pmc=3796596}}</ref>

<!--  Epidemiology and history -->
Croup is a relatively common condition that affects about 15% of children at some point.<ref name=PedN09/> It most commonly occurs between six months and five years of age but may rarely be seen in children as old as fifteen.<ref name=Croup09/><ref name=PedN09/><ref name=CMAJ2013/> It is slightly more common in males than females.<ref name=CMAJ2013/> It occurs most often in autumn.<ref name=CMAJ2013/> Before [[vaccination]], croup was frequently caused by [[diphtheria]] and was often fatal.<ref name=Cherry08/><ref>{{cite book|last1=Steele|first1=Volney|title=Bleed, blister, and purge : a history of medicine on the American frontier|url=https://archive.org/details/bleedblisterpurg0000stee|url-access=registration|date=2005|publisher=Mountain Press|location=Missoula, Mont.|isbn=978-0-87842-505-1|page=[https://archive.org/details/bleedblisterpurg0000stee/page/324 324]}}</ref> This cause is now very rare in the Western world due to the success of the [[DPT vaccine|diphtheria vaccine]].<ref name=history>{{cite book |author=Feigin, Ralph D. |title=Textbook of pediatric infectious diseases |publisher=Saunders |location=Philadelphia |year=2004 |page=252 |isbn=978-0-7216-9329-3 }}</ref>