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What Are the Symptoms of Croup?

By Amanda R. Bell
Updated May 17, 2024
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Croup typically develops due to a viral infection that causes inflammation in the windpipe and voice box. Some of the first symptoms of croup usually resemble a cold or mild flu. From this point, the patient’s voice becomes scratchy and a distinguishable cough begins to develop. As inflammation increases, the cough typically becomes worse and uncontrollable. In some cases, symptoms of croup may include difficulty breathing, while, in rare instances, a lack of oxygen may occur. Most cases of croup are relatively mild, and can be treated at home.

This relatively common childhood illness, which typically occurs in children between six months and three years old, often seems like a cold or other mild sickness at first. The patient may have a stuffy or runny nose, mild to moderate fever, and a general feeling of malaise. These symptoms of croup are usually the result of a viral infection, most commonly flu strains, adenovirus, or respiratory syncytial virus (RSV).

As the virus spreads to the windpipe and voice box, the main symptoms of croup become apparent. The patient’s voice typically becomes scratchy or hoarse, and he or she may have difficulty talking. A cough then starts to develop that does not sound like a normal cough. Most coughs, when symptoms of a cold or the flu, occur due to inflammation of the throat. As croup inflames the voice box, the cough comes out sounding very high-pitched, loud, and harsh, and is so distinguishable that it is the primary reason for how doctors diagnose croup.

This unique cough usually occurs in uncontrollable spurts as the symptoms of croup progress, and is typically worse when the patient is attempting to speak. In some instances, the patient may continuously cough for upwards of ten minutes with short breaks in between. As the virus spreads, the breathing in between the cough may sound high-pitched due to the inflammation in the windpipe and voice box, and the patient may be having difficulty inhaling and exhaling. To make up for the lack of oxygen between coughing fits, a patient may breathe very quickly.

In severe cases of this illness, symptoms of croup may include a severe lack of oxygen. The patient may become noticeably paler, and a blue tinge may develop around the outside of the mouth. If this occurs, immediate medical attention is necessary.

The most common treatment for croup is a fever-reducing pain medication. To relieve coughing spurts, breathing in moist, cool air tends to work best; the use of a cool-mist humidifier can provide this type of air, which can be especially helpful during the night. In some cases, and for young children, steroids may be used to reduce inflammation if breathing is especially difficult. Severe symptoms of croup are typically treated with breathing treatments using a nebulizer at a hospital.

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