Children's Hospital Colorado

Croup

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What is croup?

Croup occurs when there is inflammation of the upper airway (larynx and trachea) that causes a barking cough or hoarseness. The inflammation is caused by a virus.

Croup symptoms generally peak 2 to 3 days after the symptoms of the viral infection begin and typically last 3 to 7 days. Symptoms are worse at night and when the child is excited, exercising or crying.

The vast majority of children recover from croup with no complications. Rare complications of croup include a bacterial infection of the airway, dehydration from not being able to drink adequately and the need for supplemental oxygen. Children who were born prematurely or who have a history of lung disease (such as asthma) or neuromuscular disease (like cerebral palsy) are more likely to develop severe croup symptoms and often require hospitalization. Still, croup rarely causes any long-term complications.

Immediately call your doctor or get medical attention if your child has any of the following warning signs of respiratory distress:

  • Difficulty breathing, including rapid or labored breathing
  • Retractions (when the skin between the ribs pulls in with each breath)
  • Stridor (high-pitched or squeaking noise when inhaling)
  • A pale or bluish color around the mouth
  • Drooling or difficulty swallowing
  • A fatigued appearance
  • Signs of dehydration (including a dry or sticky mouth, few or no tears, sunken eyes, thirst, no urine or only a little dark yellow urine for 8-12 hours, and extreme tiredness)
  • A very sick appearance

What causes croup?

Most cases of croup are caused by viruses. Parainfluenza virus, adenovirus and respiratory syncytial virus (RSV) are the most common types of virus that cause croup. Most cases of viral croup are mild and can be treated at home. In rare occasions, croup can be severe and even life threatening.

The best way to keep your child from getting croup is practicing good hand hygiene. Wash hands before eating or touching your eyes, nose and mouth as well as after being in contact with other people with respiratory infections.

Who gets croup?

Croup tends to occur in younger children (6 months to 3 years) because their airways are smaller, and a little swelling in a smaller airway makes a bigger difference. However, it can occur in older children as well. Croup tends to develop in the fall and early winter during the peak season for the viruses. Many children who come in contact with the viruses that cause croup will not get croup, but will instead have symptoms of a common cold.

Get to know our pediatric experts.

Grace Houser, MD

Grace Houser, MD

Pulmonology - Pediatric, Pediatrics

Stacey Martiniano, MD

Stacey Martiniano, MD

Pulmonology - Pediatric, Pediatrics

Emily DeBoer, MD

Emily DeBoer, MD

Pulmonology - Pediatric, Pediatrics

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Paul Houin, MD

Paul Houin, MD

Pulmonology - Pediatric, Pediatrics