Croup guide for parents

Croup is a result of upper respiratory tract viral infection that causes swelling of the larynx and tracheal tissue. This narrowing of the windpipe makes breathing difficult for the patients and they emit a squeaky high-pitched sound when they breathe. Moreover, the laryngeal involvement results in a raspy voice and telltale ‘barking cough’. In children, the virus that causes common cold also causes croup. It can affect children up to the age of five years, and they often end up needing treatment by healthcare professionals, in particular Best ENT specialist in Lahore.

What are the symptoms of croup?

Croup itself is not a virus, rather a group of symptoms that arise secondary to a viral infection. The onset of disease is due to a virus which causes cold or flu. In the beginning parents may notice their child having a runny nose, fever and cough. Soon the symptoms progress to involve the windpipe and the larynx.

To recognize the symptoms of croup, it’s important to understand how it involves the laryngeal tissue. Normally, when we speak the air passes through the voice box or larynx which changes its shape to change the pitch and volume. However, when there is inflammation of the voice box, it cannot change its shape. Consequently, the voice is hoarse and the cough sounds harsh and barking in nature.

When it involves the trachea or the wind pipe, the inflammation narrows the pathway for air. Children have floppier and narrower windpipe compared to adults, which is why when its inflamed, breathing becomes difficulty. Additionally, the children emit a harsh sound known as stridor when they breathe. This high-pitched sound gets worse when the child becomes upset, therefore, calming a child is necessary during an acute attack.

What is mild, moderate and severe croup?

In most cases of croup, the child gets better at home within a week. However, in certain cases they can deteriorate quickly and need urgent management. Therefore, the disease is classified in mild, moderate and severe for better understanding of severity.

In mild croup the child has a noisy breathing and a cough when upset, but there is no effect on breathing. The child is almost asymptomatic during the day and the symptoms only get worse during the night. In fact, other than the cough you may not notice anything wrong with the baby.

In moderate croup the breathing is affected; you may notice the flaring of nostrils and a ‘tug’ at the neck which signifies increased work of breathing. There is involvement of accessory muscles for breathing and moderate retraction of chest wall. The child also displays mild agitation with intermittent stridor at rest and increased respiratory rate.

In severe croup the child displays increased agitation. The breathing is markedly increased in severe disease and decreased in very severe cases. In comparison to moderate croup, there is noticeable retraction of the chest wall. In life-threatening cases of croup, the patient can become hypoxic and drowsy. The stridor at this stage become persistent, even at rest.


Seek immediate help of the healthcare provider if your child’s croup gets bad. Best ENT specialist in Karachi believe in minimal handling of the patient to avoid deterioration of disease. Mild and moderate croup is managed with steroids alone, while nebulized adrenaline is added in severe cases.

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