Four Seasons Pediatrics

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Rise in Croup/Laryngitis Illness

Please review information about Croup and Laryngitis, as we are seeing a higher number of cases at this time.


Croup is a viral infection which occurs in the fall and winter.  Typically it begins with a runny nose and a loud barky or honking cough.  Most croup is caused by a virus called Para influenza, the same virus that causes laryngitis in older children and adults. It causes swelling of the vocal cords, voice box, and the breathing tube.  The fever and barky cough may last 5 days or more; and is typically worse at night. The virus can be spread from person to person like a cold.  Hand washing will limit the spread.  Cough medicine and antibiotics do not help croup.

Helpful Home Hints:
1. Keep your childs room humidified for 24 hours a day or hang some wet sheets or towels in the room (as they dry, the room will become humidified).
2. Encourage your child to drink clear fluids and less milk.
3. Do not smoke near or around your child.
4. If your child has fever or a sore throat; acetaminophen will help.

Croup Attacks:
Some children have croup attacks which consist of coughing spells accompanied by a sound which occurs while breathing in.  These can usually be controlled by one of the following:

1. Have the hot water running in the shower, with the bathroom door closed. While it is steaming up proceed to step
2. Open the freezer door and have your child breath in the mist from the freezer; if this does not allow significant improvement within 5-10 minutes proceed bring your child into the bathroom; which should be steamed up.  If this does not allow improvement within 5-10 minutes; proceed to step
3. Wrap your child in a blanket and take a walk in the cool night air.

Call Immediately if:

1. The above measures do not work.
2. Your child is breathing fast, has blue lips or looks uncomfortable.
3. Your child is drooling or not swallowing right.
4. Your child is unable to lie down comfortably and wants to sit up.
5. Your child is unable to bend his neck forward.
6. If your child could be choking on something that was put in the mouth.
7. It started suddenly after taking a medication, an insect bite or new food.
8. The temperature is greater than 103 degrees.
9. Your child is not drinking well and has not been urinating at least 3 times in the last 24 hours.

Spasmodic croup:
Spasmodic croup is related to infectious croup. However, its cause and symptoms are slightly different.  Most cases of spasmodic croup are caused by an allergic reaction. Viruses may trigger the allergic reaction in some cases. In rare cases, the airway irritation seems to be triggered by regurgitated (refluxed) stomach acid.

Spasmodic croup is a type of croup that is not infectious.  Differences include no fever and the symptoms typically last a shorter time than is the case for infectious croup.  Currently in the United States, infectious and spasmodic croup together account for about 15 percent of all respiratory illnesses seen by pediatricians. Infectious croup is most common in children younger than age 6, and boys are affected slightly more often than girls. Spasmodic croup usually strikes children who are older.

Instead of having a fever or cold symptoms, the child with spasmodic croup often looks fairly healthy before coughing starts. The rest of the family is usually not sick with any respiratory illness. Episodes of cough and loud, raspy breathing generally start without warning, often in the middle of the night. These symptoms often will pass if the child is carried into cool night air or taken into a steamy bathroom. Symptoms from spasmodic croup typically improve within a few hours, although it is common for the symptoms to reappear several nights in a row.

In most cases, we diagnose spasmodic croup based on your child’s recurrent history, symptoms and physical findings.

Treatment for spasmodic croup is similar to viral croup.

Other factors to consider:

Cover mattress and pillow allergy cover.
Limit dust collectors, like dressers, stuffed animals

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