The most common cocci implicated are Staphylococcus aureus and Streptococcus pneumoniae, while the most common bacteria are Haemophilus influenzae, and Moraxella catarrhalis. Laryngeal diphtheria is due to Corynebacterium diphtheriae while bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis are usually due to a primary viral infection with secondary bacterial growth. Bacterial croup may be divided into laryngeal diphtheria, bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis. Bacteria and cocci Ĭroup caused by a bacterial infection is rare. Treatment, and response to treatment, are also similar. Spasmodic croup is caused by the same group of viruses as acute laryngotracheitis, but lacks the usual signs of infection (such as fever, sore throat, and increased white blood cell count). Other viral causes include influenza A and B, measles, adenovirus and respiratory syncytial virus (RSV). Viral croup or acute laryngotracheitis is most commonly caused by parainfluenza virus (a member of the paramyxovirus family), primarily types 1 and 2, in 75% of cases. The first two conditions involve a viral infection and are generally milder with respect to symptomatology the last four are due to bacterial infection and are usually of greater severity. Others use the term more broadly, to include acute laryngotracheitis ( laryngitis and tracheitis together), spasmodic croup, laryngeal diphtheria, bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis. Causes Ĭroup is usually deemed to be due to a viral infection. Drooling or a very sick appearance can indicate other medical conditions, such as epiglottitis or tracheitis. Other symptoms include fever, coryza (symptoms typical of the common cold), and indrawing of the chest wall–known as Hoover's sign. As croup worsens, stridor may decrease considerably. The stridor is worsened by agitation or crying, and if it can be heard at rest, it may indicate critical narrowing of the airways. The "barking" cough is often described as resembling the call of a sea lion. Problems playing this file? See media help.Ĭroup is characterized by a "barking" cough, stridor, hoarseness, and difficult breathing which usually worsens at night. This cause is now very rare in the Western world due to the success of the diphtheria vaccine. Before vaccination, croup was frequently caused by diphtheria and was often fatal. It is slightly more common in males than females. It most commonly occurs between six months and five years of age but may rarely be seen in children as old as fifteen. Ĭroup is a relatively common condition that affects about 15% of children at some point. Hospitalization is required in one to five percent of cases. In more severe cases inhaled epinephrine may also be used. Croup is usually treated with a single dose of steroids by mouth. Most cases of croup are mild and the patient can be treated at home with supportive care. Many cases of croup are preventable by immunization for influenza and diphtheria. Further investigations, such as blood tests, X-rays and cultures, are usually not needed. Croup is typically diagnosed based on signs and symptoms after potentially more severe causes, such as epiglottitis or an airway foreign body, have been ruled out. Rarely is it due to a bacterial infection. Ĭroup can be caused by a number of viruses including parainfluenza and influenza virus. Often it starts or is worse at night and normally lasts one to two days. These symptoms may be mild, moderate, or severe. Fever and runny nose may also be present. The infection leads to swelling inside the trachea, which interferes with normal breathing and produces the classic symptoms of "barking/brassy" cough, inspiratory stridor and a hoarse voice. Usually 1–2 days but can last up to 7 days Įpiglottitis, airway foreign body, bacterial tracheitis Ĭroup, also known as laryngotracheobronchitis, is a type of respiratory infection that is usually caused by a virus. "Barky" cough, stridor, fever, stuffy nose
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