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Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Families
Croup
This information sheet from Great Ormond Street Hospital (GOSH) explains
the causes, symptoms and treatment of croup and where to get help.
Croup is a common childhood
condition that affects the upper part
of the respiratory system – the trachea
(windpipe), bronchi and larynx (voice
box). It causes noisy breathing, a
barking cough and sometimes a hoarse
voice. Occasionally, severe croup can
cause breathing difficulties, which
may require a short stay in hospital. In
most cases, however, croup gets better
without needing any treatment.
Pharynx
Epiglottis
Larynx
Trachea
Bronchus
Bronchiole
Alveolus
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What causes croup?
There are two kinds of croup:
„„Viral croup (laryngotracheitis) – this
is the most common type, caused by a
viral infection.
„„Spasmodic croup – less common and
caused by an allergic reaction, this type
usually comes and goes in short episodes.
Croup tends to affect young children
aged between six months and three
years, although it can sometimes affect
older children. Boys tend to develop
croup more often than girls, although
we do not understand why this is the
case. Croup is most common in autumn
and winter, when there are more viruses
present in the atmosphere.
What are the signs and
symptoms of croup?
Initially, the symptoms of croup are
similar to those of the common cold
– that is, a sore throat, runny nose,
raised temperature and a cough. The
characteristic symptoms of croup develop
a few days later. The child will develop
a barking cough, hoarse voice and noisy
breathing (stridor). The symptoms tend to
be worse at night. They also worsen when
the child cries or is upset.
© GOSH NHS Foundation Trust February 2015
How is croup diagnosed?
Croup can be diagnosed by your family
doctor (GP) who will take a medical
history, check for the symptoms and look
in the child’s throat. They will usually
take the child’s temperature to see if it
is higher than usual. Occasionally, they
may take a throat swab to identify the
virus causing croup but in many cases,
the symptoms have cleared up before the
virus has been identified. Identifying the
virus is not essential to diagnose croup
but may help doctors monitor viruses
circulating in the population.
atmosphere, for instance, the bathroom,
be extremely careful that your child does
not come into contact with steam or hot
water to avoid scalding.
As croup is caused by a virus, antibiotics
will not be helpful as these only work
against bacterial infections. Likewise,
cough mixtures will not ease your
child’s cough.
In some cases, the breathing difficulties
are severe enough to need a short stay in
hospital, sometimes with steroid medicines
to reduce the swollen airway and extra
oxygen if their blood levels are low.
How is croup treated?
What happens next?
In many cases, croup gets better without
treatment. Keeping your child in an
upright position can ease their coughing.
Their symptoms will worsen when upset
or crying so plenty of cuddles and comfort
can help. If your child is running a high
temperature, you should try to bring this
down using medication. For instance,
paracetamol or ibuprofen, but check
with your pharmacist or doctor if you
have any questions. There is also a risk
of dehydration, so ensure that your child
drinks plenty of fluids.
Most children are clear of croup symptoms
within 48 hours and have no lasting
effects of the condition. Occasionally, a
child may develop a secondary bacterial
infection such as pneumonia or a middle
ear infection following croup as viral
illnesses can increase the risk of developing
a bacterial infection but this is rare.
In the past, steam has been used to help
the symptoms of croup, but there is
little evidence that it is successful. If you
want to take your child into a steamy
Further information
and support
Talk to your family doctor (GP)
Compiled by the Critical Care and Cardiorespiratory team
in collaboration with the Child and Family Information Group
Great Ormond Street Hospital for Children NHS Foundation Trust
Great Ormond Street,
London WC1N 3JH
www.gosh.nhs.uk
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Ref: 2014F1536
© GOSH NHS Foundation Trust February 2015