Croup is breathing difficulty and a “barking” cough. Croup is due to swelling around the vocal cords. It is common in infants and children.


Croup is most often caused by viruses, such as parainfluenza RSV, measles, adenovirus, and influenza. It tends to appear in children between 3 months and 5 years old, but it can happen at any age. Some children are more likely to get croup and may get it several times. It is most common between October and March, but can occur at any time of the year.

More severe cases of croup may be caused by bacteria. This condition is called bacterial tracheitis.

Croup may also be caused by:

  • Allergies
  • Breathing in something that irritates your airway
  • Acid reflux


The main symptom of croup is a cough that sounds like a seal barking.

Most children will have mild cold symptoms for several days before the barking cough becomes evident. As the cough gets more frequent, the child may have trouble breathing or stridor (a harsh, crowing noise made when breathing in).

Croup is typically much worse at night. It often lasts 5 or 6 nights. The first night or two are most often the worst. Rarely, croup can last for weeks. Talk to your child’s doctor if croup lasts longer than a week or comes back often.

Exams and Tests

Children with croup are most often diagnosed based on the parent’s description of the symptoms and a physical exam. Sometimes a doctor will listen to a child cough over the phone to identify croup. In a few cases, x-rays or other tests may be needed.

A physical exam may show chest retractions with breathing. When listening to the child’s chest through a stethoscope, the health care provider may hear:

  • Difficulty breathing in and out
  • wheezing
  • Decreased breath sounds

An exam of the throat may reveal a red epiglottis. A nck x ray may reveal a foreign object or narrowing of the trachea.


Croup is most often mild, but it can still be dangerous. It usually goes away in 3 to 7 days.

The tissue that covers the trachea (windpipe) is called the epiglottis. If the epiglottis becomes infected, the entire windpipe can swell shut. This is a life-threatening disease.

If an airway blockage is not treated promptly, the child can have severe trouble breathing or breathing may stop completely

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