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A contagious viral infection of the upper and lower airways is known as croup. This infection will usually manifest in children causing difficulty in breathing, especially when inhaling. It can be caused by a number of different viruses. A para-influenza virus during the fall months of the year is the most likely cause. But croup can also be caused by the measles virus, respiratory syncytial virus or an influenza virus during the winter and spring months. Primarily croup will affect children between the ages of 6 months and 3 years. But it can also affect a child that is younger or older. When croup is caused by the influenza virus it is more likely to occur in children that are 3 to 7 years old. It is spread by breathing airborne droplets containing the viruses or through contact with infected objects.
The symptoms of croup will start out much like a cold. The infection will cause swelling of the lining of the airway causing it to narrow and make breathing difficult. It is characterized by a difficulty when inhaling, a barking cough and hoarseness that will usually occur the first night. A child that has contracted croup will be wakened by difficulty in breathing. Their breathing will be rapid and deep, usually accompanied by a fever. During the morning hours the child's condition may improve but worsen at night. This illness will last approximately 4 days. If croup continues to repeat itself in the child it is likely to be spasmodic croup. In some cases allergies seem to be the cause of spasmodic croup, but in most cases it will prove to be cause by a viral infection. A physician can distinguish which type of croup a child has by its characteristic symptoms.
If the child has a mild case of the croup, he or she can be cared for at home. Make the child comfortable and give them plenty of fluids. Make sure the child gets plenty of rest since crying and fatigue will cause the condition to worsen. Humidifiers or cool mist vaporizers may reduce the drying of the upper airway and ease the childs breathing. Running a hot shower to steam up the bathroom is a quick way to increase the humidity and works well at the onset of the virus. Any time the child has continued difficulty in breathing, rapid heart rate, fatigue, bluish skin discoloration or dehydration they should be hospitalized. At the hospital the child will be given oxygen if the blood levels of oxygen are low. If high carbon dioxide levels are detected in the blood it is a sign that the child is becoming exhausted. They may be given mechanical assistance with breathing by having a tube inserted into the airway to pump air in and out of the lungs using a ventilator.
The child may also need an ultrasonic nebulizer. This is different from a home humidifier in that it can produce sufficient small droplets to reach the lower airways and reduce the stickiness of secretions there. Then these secretions can be more easily cleared out by coughing. Some drugs, such as epinephrine which widens the airway, may be given to the child to breath through the nebulizer. The child may be given corticosteriods for the early treatment of severe viral croup but this treatment is still controversial. In a rare situation antibiotics are used when a child with croup has developed a bacterial infection.