DEFINITION
Croup (laryngotracheobronchitis) is inflammation of the
airways, the trachea and larynx, which is caused by a viral infection that is
contagious, causing cough, stridor, and sometimes difficult to draw breath.
CAUSE
Croup is caused by a viral infection that causes swelling of
the airway surface, especially in the area below the larynx, so that the airway
becomes narrower. The most common cause is a para-influenza virus. In addition
croup can also be caused by other viruses, such as respiratory syncytial virus
(RSV) or influenza virus.
Croup primarily affects children aged 6 months to 3 years,
but sometimes also the younger children or older.
Croup caused by influenza viruses can be very severe and can
occur in a broader age range in children. The infection usually spreads through
saliva splashes that contain viruses or contact objects contaminated with
saliva of patients.
Most children only suffered one attack of croup, but some
children may experience recurrent croup attack due to the severity of the viral
infection and recurrence of diminishing returns.
SYMPTOMS
Croup is usually preceded by symptoms that resemble the flu,
the runny nose, sneezing, mild fever, and sometimes cough. Then the child's
voice becomes hoarse and frequent cough with unusual sounds, loud or as
meyalak. Symptoms of croup varies from severity.
Sometimes swelling of the airways causing difficulty
breathing children, most clearly seen when the child breathe. Approximately 50%
of children with croup have a fever. All the symptoms are usually more severe
at night and may awaken the child from sleep. The child's condition usually
improves in the morning, but came back worse at night.
Other symptoms that may be found:
- Cyanosis (bluish skin color due to lack of oxygen)
- Intercostal retractions (increased use of the muscles of
the neck and chest in an effort to breathe)
DIAGNOSIS
Croup usually recognizable from the typical symptoms and a
physical examination. X-ray radiographs of the neck and chest can help the
doctor to confirm the diagnosis.
TREATMENT
If a child has a cough that is similar to the symptoms of
croup, then the child should be immediately taken to the doctor because of
croup could quickly become heavy.
Generally, if the disease is mild, the child with croup can
be treated at home and usually improve within 3-4 days. This kid needs to be
made as comfortable as possible, rest, and given enough water because fatigue
and crying will aggravate the condition. At home can use a humidifier to
moisten the air, thus reducing dryness of the upper airway and ease breathing.
Humidity can also be enhanced by the provision of hot water vapor.
For more severe disease, can be given a single dose of
corticosteroids to prevent symptoms worsen. Children with croup who continues
to be immediately went to the doctor and usually need to be hospitalized.
Children who have difficulty breathing, tightness, increased heart rate,
fatigue, or blue need to be given oxygen and intravenous fluids. Treatment
given aims to overcome airway swelling, for example by administering nebulizer.
Antibiotics are only used in case of a bacterial infection. In rare cases,
breathing can be assisted with breathing aids (ventilator). Fortunately, most
children with croup can be fully restored.
PREVENTION
Frequent hand washing and avoiding contact with people who
are affected by respiratory tract infection is the best way to prevent the
spread of the virus that causes croup.
REFERENCE
- K, Anand D .; M, John T. Croup. Merck Manual Home Health
Handbook. 2009.
- D, Yamini. Croup. Kidshealth. 2012.
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