Croup (technically known as ‘laryngotracheobronchitis’) is a condition characterized by swelling inside the throat preventing normal breathing and resulting in a well known ‘barking’ type cough along with a hoarse voice. The symptoms can be mild to severe and are often worse at night. The condition is usually the result of a viral infection in the upper airway.
In most cases croup is treated with a single dose of steroids administered orally. Steroids found to be successful include corticosteroids such as dexamethasone and budesonide. Usually this will result in almost immediate relief within six hours after administration in all severities and usually no more is required.
In some cases croup can be temporarily improved using nebulized epinephrine which is effective for around 10-30 minutes though the results do not last more than four hours (sometimes just two). Thus epinephrine can be used as an intermediate treatment prior to the use of steroids.
There are currently no other known treatments for croup, though several have been tested. Sometimes the inhalation of hot steam is suggested, though there are no studies to demonstrate this as being statistically effective. The use of cough medicines are generally discouraged.
The prognosis for croup is largely good and the disease is a self limiting one. However if the patient does not get immediate treatment then in rare cases they may suffer respiratory failure or cardiac arrest. Symptoms should improve after two days and be completely gone by seven days.