Croup — Causes, Symptoms, Treatment, and Prevention Strategies

Croup (嘶哮症) is a viral infection affecting the larynx and trachea, causing localized swelling and airway narrowing. It commonly occurs in children aged 6 months to 5 years, though older children may also be affected. Due to its potential for rapid worsening, parents must take its clinical signs and treatment seriously, seeking immediate medical attention if dangerous symptoms like breathing difficulties arise.

Symptoms of croup

In its early stages, croup symptoms resemble a common cold—fever, runny nose, and mild cough. As the condition progresses, the cough becomes rough and takes on a distinctive barking sound, often accompanied by hoarseness. During inhalation, narrowed airways may produce a high-pitched wheezing sound; in severe cases, the skin between the ribs or below the neck visibly retracts due to labored breathing, indicating significant respiratory effort.

Symptoms typically worsen at night, peaking on the second or third night. Parents should closely monitor their child’s nighttime condition, noting breathing rate, signs like blue lips, or other red flags signaling deterioration. Frequent moaning, rapid breathing, or dry cough at night warrants prompt contact with a medical facility for further evaluation and treatment.

Croup is primarily caused by parainfluenza viruses, though influenza viruses and respiratory viruses can also be culprits. These viruses spread via droplets or direct contact with an infected person, often when a child touches their eyes, nose, or mouth after exposure. Notably, while some parents believe steam therapy or humidifiers alleviate symptoms, current scientific evidence does not sufficiently support their effectiveness. Focus should instead be on symptom management and timely treatment.

Therapy and Home Care

For mild croup cases, home care is usually sufficient. Common symptomatic treatments include paracetamol (撲熱息痛) or ibuprofen (布洛芬) to control fever and relieve pain. Parents should ensure adequate rest and hydration to aid viral clearance and recovery. However, if the child develops breathing difficulties, blue lips, drooling, or swallowing issues—along with evident chest or neck retractions—immediate medical attention is essential. In such cases, doctors typically prescribe oral steroids like prednisolone (潑尼松龍) or dexamethasone (地塞米松) to quickly reduce airway swelling and ease breathing.

Prevention is equally critical. Homes and daycare centers should maintain good hygiene, especially during peak seasons, with enhanced ventilation and cleaning to limit contact between symptomatic children and others. Teaching children to wash hands frequently and keep eyes, nose, and mouth clean reduces infection risk. For high-risk children, such as those with asthma or other respiratory conditions, parents should consult doctors about potential preventive use of inhaled medications.

In summary, croup (嘶哮症) is a common acute respiratory infection in children, characterized by barking cough, wheezing, laryngeal and tracheal swelling, and nighttime worsening. Understanding its causes, early recognition, and targeted treatment are vital for symptom relief and complication prevention. Parents should stay vigilant, monitor breathing, and seek timely medical care when needed to ensure swift recovery and a return to normal life. With proper home care, evidence-based medication, and strict prevention, most children improve within a short period, minimizing long-term health risks.