Laryngotracheobronchitis (CROUP)

General Illness Information

Medical Term:
CROUP (Laryngotracheobronchitis)

Common Name: Croup

Description: Croup is a contagious viral infection causing inflammation and swelling of the larynx and surrounding tissues. It presents with difficulty in breathing especially breathing in and a typical barking cough.

It usually affects children between the ages of 6 months and 3 years.

Causes: Croup can be caused by a number of different viruses.

  • In the fall, it is usually caused by para influenza virus.
  • In winter and spring, it is usually caused by respiratory syncytial virus or an influenza virus.
  • Less commonly, croup may be caused by measles virus or other viruses such as adenovirus, rhinovirus,enterovirusand coxsackievirus.

Prevention: No specific preventive measures.

Signs & Symptoms

  • Stridor – a harsh, raspy vibrating sound heard when the child breathes in. This is usually present when the child is agitated but in severe cases may be present even at rest. Stridor occurs when the opening between the vocal cords becomes narrower.
  • Difficulty in breathing may awaken the child from sleep.
  • Fever.
  • The child’s condition may improve in the morning but worsen at night.
  • Usually lasts 3 to 4 days.

Risk Factors

  • Allergies.
  • Repeated upper respiratory infections.
  • Previous croup.

Diagnosis & Treatment

Diagnosis is generally made on history and physical examination. Diagnostic tests may include throat culture, neck x-ray or CT scan, and laryngoscopy.

General Measures:

  • The mildly ill child may be cared for at home with supportive therapy.
  • Dry air makes the cough worse- humidify the room with a cool mist humidifier.
  • Stay calm. Anxiety and crying makes the symptoms worse. Keep the child relaxed by reading a story or watching television.
  • Offering warm fluids may help as it looses the sticky mucus caught in the throat (e.g. apple juice, tea and lemonade).
  • Keep the child comfortable in a semi-seated position.
  • Steam from a hot shower may help breathing. Take the child into a steamed up bathroom for 10 minutes. Cuddle him to calm his fears.


  • Usually not necessary as croup is due to a viral infection. Antibiotics are prescribed if it is a bacterial infection.
  • Fever is treated with acetaminophen.


Decrease the child’s activity and encourage rest as long as croup attack persist.


Encourage fluids. Offer frequent small amounts of fluids, such as water, ginger ale, tea or juice or cola. Coughing may cause vomiting, so do not give the child solids during an attack.

Possible Complications :

  • Pneumonia
  • Ear infection
  • Airway obstruction and death (rare)


Croup can be frightening, because attacks usually happen at night, and the child has trouble breathing. In most cases , croup is not serious.

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