Pseudo croup

Overview

Pseudo croup is a very common form of the croup syndrome. A virus infection causes inflammation and narrowing of the upper airways, resulting in the characteristic spasmodic, barking cough, in particular at night. Often, the symptoms can be relieved by simply breathing in fresh and cool air or inhaling moist, warm air while remaining at rest.

Symptoms

• Spasmodic, barking cough
  • Sudden onset, in particular in the late evening and during the night
  • Often only occurs two to three hours after the child has been put to bed
• Hoarseness, sometimes even loss of voice
• High-pitched whistling sounds when breathing
• Good to slightly impaired general health
• Often, there have already been symptoms of a cold for a few days
• Body temperature is normal or only slightly elevated
• Typical warning signs for parents of an imminent attack: the cough changes towards the evening from a superficial cough to a deep, dull cough
• The symptoms usually subside without complications after a few days
• Complication:
  • Shortness of breath, possibly bluish discolouration of the lips (cyanosis)
  • In extreme cases, danger of suffocation

Causes and treatment

Cause

• Usually preceded by a viral infection of the airways
  • 75% of cases caused by parainfluenza viruses
  • Inflammation of the mucous membranes of the larynx and trachea, sometimes also the bronchial tubes
• Risk factors
  • Usually affects children between the ages of 3 months and 5 years
  • Individual predisposition is suspected
  • During the cold season, mainly in autumn and winter

Further treatment by your doctor / in hospital

Possible tests

• Listening to the lungs
• Checking the oxygen saturation

Possible therapies

• General: calming down, breathing in cold air
• Depending on the severity
  • Nebuliser for inhalation of saline solution
  • Inhalation of cortisone or adrenaline
  • Cortisone as suppository or intravenous
  • Oxygen administration, if necessary
  • Intensive medical monitoring, if necessary
  • Rarely: intubation to secure the airways (artificial respiration)

What can I do myself?

• There are no known preventive measures (including no vaccination)

If there are no symptoms causing alarm (see below):

• First: calm the child and remain calm yourself
• Make sure the air is moist and cold or moist and warm
  • Electric humidifiers are suitable (vaporisers are best)
  • Steam from the shower
  • Take the child out into the fresh and cold air
  • It’s difficult to predict the best method in advance
• If the child has calmed down and it seems necessary: inhalation with medication prescribed by the doctor
• As soon as the child allows it: cooling throat compresses, if necessary
• Sitting up – also in bed – makes it easier to breathe
• Mucus-loosening cough syrup, if necessary

When to see a doctor?

• No improvement after an hour at most

Symptoms causing alarm for which emergency medical treatment is needed:

• High fever (above 38 degrees)
• Signs of shortness of breath
  • Skin and muscles around the ribs get sucked in when the child breathes
  • Bluish discolouration of the lips (cyanosis)
  • Fear of suffocation
• Muffled speech and rattling when breathing out
• Excessive salivation
• Significantly accelerated pulse
• Disorientation

Synonyms

pseudo croup, pseudo-croup, false croup, croup syndrome, subglottic laryngitis, spasmodic croup, viral croup, laryngotracheobronchitis