Croup - Symptoms

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What are croup symptoms?

Viral croup can have two distinct presentations, both of which are a consequence of swelling of the vocal cords resulting in a narrowing of the airway. The more common variety has symptoms of fever (100 F-103 F), mild hoarseness, and sore throat two to three days after virus exposure. Quick to follow is the characteristic dry "barking seal" cough that may be associated with a harsh, raspy sound during inspiration. (This sound, called "stridor," has been noted to resemble the breathing of the Star Wars character Darth Vader.) The symptoms commonly last for four to seven days.

The alternative and less frequent presentation is called "acute spasmodic croup." These children will appear totally well when put to bed at night only to awaken their parents in the middle of the night with the above described barky cough and stridor. Fever and sore throat are not noted in these children, and the symptoms commonly resolve within eight to 10 hours from onset, and the child appears totally well until this same acute onset recurs the following night. This on/off pattern may occur over three to four nights in a row and then morph in to symptoms more characteristic of the common cold -- mucus-like nasal discharge and a "wet" cough for several days.

These two different presentations are the result of the particular virus that has infected the child. Manifestations of croup vary from mild (common) to life-threatening (rare). The severity of symptoms is proportional to the amount of relative narrowing of the airway. The more severe the vocal cord narrowing the more effort is required to inhale. A severely sick child will refuse to lie down, demanding to remain in an upright position. They will show retractions of the skin above the collarbone and between the ribs with inspiration and may develop facial cyanosis (bluish skin discoloration). Apparent exhaustion and decreased respiratory effort are an indication of impending respiratory failure and are cause for immediate paramedic evaluation and transport to the emergency department of the closest hospital.

In general, the duration of symptoms of croup is five to seven days. More severe croup may resolve in 14 days.

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See what others are saying

Comment from: mom of_Tand_H, 3-6 Female (Caregiver) Published: January 27

My 5 year old went to bed fine at 7:45 pm and at 11:15 pm she has severe trouble breathing. She sounded odd and strange, struggling to get the next breath. It was scary, she had a 101.8 fever. Her face was nearly purple. I held her up for a few hours. Put a warm wash cloth on her and gave her Vicks vapor rub. She coughed and coughed more and more struggle to breath. At 4:00 am I was ready to take her to the ER. About that time she finally fell asleep on me. At 8:30 am she woke up and began the whole thing again. We went directly to our Peds. Dr. and he knew by what he called the barking seal sound that she had croup. He gave us steroids and to monitor her. It was very, very scary.

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Comment from:, 3-6 Male (Caregiver) Published: November 18

My mother is suffering from dizziness and vomiting. She can't hear from one ear and this vertigo happened once a month. But these days it is happening once a week.

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