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PediatricICD-10: J05.0Accounts for about 15% of emergency department visits for pediatric respiratory illness

Croup

Also known as: Laryngotracheobronchitis, Barking Cough, Viral Croup

Croup is a common childhood respiratory illness that causes swelling around the vocal cords and windpipe, resulting in a distinctive barking cough and stridor (a harsh breathing sound). It primarily affects children between 6 months and 3 years of age and is most often caused by parainfluenza viruses. Most cases are mild and can be managed at home, though severe croup may require medical treatment to reduce airway swelling.

Symptoms

Distinctive barking, seal-like cough
Stridor (harsh, high-pitched sound when breathing in)
Hoarse voice
Difficulty breathing that worsens at night
Low-grade fever
Runny nose and cold-like symptoms preceding the cough

Causes

  • Parainfluenza viruses (most common cause, types 1 and 3)
  • Other respiratory viruses (RSV, influenza, adenovirus)
  • Inflammation and swelling of the larynx, trachea, and bronchi

Risk Factors

  • Age between 6 months and 3 years
  • Born prematurely or with a narrow airway
  • Fall and early winter season (peak season)
  • Exposure to other children in daycare settings

Diagnosis

  • Clinical diagnosis based on characteristic barking cough and stridor
  • Assessment of respiratory distress severity (Westley croup score)
  • Neck X-ray showing steeple sign (narrowing of subglottic airway) if needed
  • Pulse oximetry to assess oxygen levels

Treatment

  • Cool mist humidifier or exposure to cool night air
  • Oral dexamethasone (single dose—highly effective)
  • Nebulized epinephrine for moderate-to-severe stridor
  • Comfort measures (keep child calm; crying worsens symptoms)
  • Fluids to prevent dehydration

Prevention

  • Frequent handwashing to reduce viral transmission
  • Keep children away from people with respiratory infections
  • Influenza vaccination may prevent some croup cases

When to See a Doctor

  • Your child develops stridor at rest (not just when crying or active)
  • Your child has difficulty breathing, drooling, or cannot swallow
  • Lips or skin appear bluish or pale—call 911
  • Your child appears anxious, agitated, or extremely lethargic

Frequently Asked Questions

Related Conditions

Asthma

Respiratory

Bronchitis

Respiratory

Common Cold

Infectious

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.