What are the symptoms of croup?
The symptoms of croup include:
- Cough, which is usually harsh and barking. This croupy cough is due to inflammation and swelling of the vocal cords in the voice box (larynx).
- Breathing symptoms. The infection causes inflammation on the inside lining of the breathing tube. There may also be a lot of thick mucus. A combination of these can cause narrowing of the breathing tube. The narrowed tube may cause noisy breathing (stridor). Breathing may become difficult if the narrowing becomes worse.
- Other symptoms that may occur include a runny nose, hoarseness and sore throat. Croup may follow a cold but can also appear without any earlier illness. Other cold or flu-type symptoms may also occur. For example, a high temperature (fever), feeling unwell, being off food and general aches and pains.
The symptoms are often worse at night. Typically, during the day a child may have a croupy cough with cold symptoms but not be too unwell. However, at night the cough and breathing symptoms often become worse.
Symptoms usually peak after 1-3 days and then improve. A mild but irritating cough may last a further week or so.
An infection by a virus that causes croup in a young child may cause a cough or sore throat in an older child or adult but is unlikely to cause the breathing symptoms of croup (described below). However, rarely, symptoms of croup can occur in teenagers or adults.
How serious is croup?
Symptoms are often fairly mild but sometimes become severe. Many children just get a croup cough with some cold symptoms. Any breathing difficulty is often mild. Parents can expect to have one or two disturbed nights nursing a coughing child. Most children with croup remain at home and soon recover.
The main concern is if severe narrowing of the breathing tube develops. If this occurs then breathing can become difficult. About 1 in 10 children with croup are admitted to hospital for observation. This is usually if symptoms suggest a narrowing of the breathing tube. Most children admitted to hospital come home within 24 hours as symptoms usually improve quickly. In a small number of cases, a ventilator is needed to help the child to breathe. This is just for a short period whilst the infection and inflammation settle down.
Further reading and references
Croup; NICE CKS, September 2012 (UK access only)
Bjornson CL, Johnson DW; Croup in children. CMAJ. 2013 Oct 15185(15):1317-23. doi: 10.1503/cmaj.121645. Epub 2013 Aug 12.
Russell KF, Liang Y, O'Gorman K, et al; Glucocorticoids for croup. Cochrane Database Syst Rev. 2011 Jan 19(1):CD001955.
Bjornson C, Russell K, Vandermeer B, et al; Nebulized epinephrine for croup in children. Cochrane Database Syst Rev. 2013 Oct 10(10):CD006619. doi: 10.1002/14651858.CD006619.pub3.
I usually wake up with this weird feeling my lower throat/chest. There is no pain. I don't feel blockage in my throat or feel like something needs cleared but I cough to think it helps somehow. It's...sara59945
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