Understanding Croup or Laryngotracheobronchitis

Our surrounding environment harbours a variety of micro-organisms, which attack our respiratory tract, via the air we breathe. A very common respiratory disease of children is croup or laryngotracheobronchitis. The literal meaning of the word croup is "to cry hoarsely".

 The causative organism is a virus-chiefly parainfluenza virus type 1

This disease generally affects small children. Children are delicate and require extra attention. It is therefore, important to understand the disease and its prevention.

As the disease progresses, it involves the prominent air passage – trachea. The exudates produced cause the inflammation and edema of subglottic area. The consequence is narrowing of the air passage and stridor is produced, which a typical breath sound is caused due to narrowed breathing passage.  Presence of barking cough and fever is also noticed.

The disease usually affects children within the age group of 3 months to 3 years. Croup is generally uncommon beyond 6 years of age. The disease is seen to last for 3-5 days, but may be prolonged for 10-15 days also. It is a self-limiting disease; oftentimes it proves to be fatal.

The prevention from the disease can be achieved by proper immunization for influenza and diphtheria.

It is vital to mention few important measures to follow while handling a child with croup:

1.     Keep the child calm, as much as possible

2.     Avoid actions, agitating the affected child and aggravating his distress.

3.     It is good to give oxygen via ‘blow-by’ technique.(holding oxygen source near the face of the child)

4.     Regular attacks of croup reveal the lacuna in immunity of the child which can be enhanced by giving proper nutrition and other vitamins and supplements.

5.     In severe conditions, steroids like dexamethasone and budesonide are found to be highly effective.

Croup should not be confused with gastrointestinal foreign bodies, tracheal foreign bodies, epiglottis, foreign body ingestion, etc.  Proper consultation with an otorhinolaryngologist is recommended if the situation deteriorates.

If cough persists, probability of croup should not be ruled out in small children. It is condition which requires proper care and should not be taken casually.