False croup

False croup is a condition in the airways. It usually occurs in small children. When an infant has a cold, their upper airways get inflamed. If the larynx then becomes inflamed too, this is called false croup.

Typical symptoms include a barking cough, a rasping sound when breathing in, and a slight shortness of breath. The symptoms usually disappear again on their own.

The term “false croup” differentiates it from “true croup”: “true croup” is actually diphtheria, a bacterial infection. Moreover, false croup also describes the location of the swollen mucous membrane in the upper airways (croup).

Medical practitioners refer to false croup by the term Laryngitis subglottica. This can be translated as “an infection of the larynx below the vocal chords”.

For more detailed information, for example on what false croup is, go to gesundheitsinformation.de.

False croup often begins with a common cold, rhinitis, and a slightly elevated temperature. The problems typically begin after a few days, and then usually occur in the evening or at night.

Typical symptoms of false croup include: 

• barking cough
• a rasping or whooping sound when breathing in
• hoarseness

Shortness of breath is another typical symptom. Because the swelling narrows the larynx, children breathe more rapidly and deeply. While most children are only slightly short of breath, the feeling often makes them scared and they start to cry, which can make them even more breathless.

Particular cold viruses are usually responsible for false croup: parainfluenza viruses often only cause coughing, rhinitis and hoarseness. But sometimes the mucous membrane in the larynx gets inflamed and swells up.

False croup often occurs in the autumn or winter. Those most commonly affected are children between the age of 6 months and 3 years. Around 3 in 100 children of that age get false croup each year. Adults only rarely get false croup.

A child often has a common cold, rhinitis, and a slightly elevated temperature. After a few days they can then get typical false croup symptoms, usually suddenly during the night. Most children only have mild symptoms that fade away on their own within 2 days.

The emergency number (112) must be called and medical help requested if the child is extremely short of breath.

A warning sign that things are becoming more serious is if the skin between the ribs is sucked visibly inwards each time the child breathes in. The child will occasionally be so short of breath that they turn blue in the face, or become so drained that they are absent and listless.

The reason for this type of problem may be, for example, that the airways are also inflamed and narrowed. A purulent inflammation of the epiglottis may also be the cause. In this case, a laryngoscopy may be necessary to determine this.

If a bacterial inflammation is suspected, a throat swab is also sometimes taken.

It is important that parents remain as calm as possible in these situations. Parents should calm their child because anxiety may make them even more short of breath.

Most children only have mild symptoms. These should disappear on their own within 2 days. In such cases, no medication is required. People are often advised to provide lots of air if a child has false croup. Fresh, cool, moist air is said to alleviate the symptoms. But these measures have not been scientifically proven to be effective.

If the symptoms are troubling the child very much, or if they are not improving, a doctor should be consulted. The child should be taken to hospital if they are very short of breath.

The doctor will usually then administer drugs containing cortisone for a short period. The child may be given these as a suppository or tablet, but occasionally too as an injection or spray.

This medication acts against the inflammation. It reduces the swelling of the mucous membrane. The child will then improve within a few hours. This short-term, and sometimes one-off, medication rarely results in any side effects.

Adrenalin is administered if the child is extremely short of breath. The child breathes it in using a nebulizer. The adrenalin makes the blood vessels in the mucous membrane contract and the swelling usually goes down in around half an hour. Possible side effects are a racing heart and an increased blood pressure, but these are not dangerous. 

A child who is extremely short of breath will usually be given oxygen via a nasal mask, as well as the drugs.

It is important to stay as calm as possible, to be there for the child, and to calm them so that their own anxiety does not leave them even more short of breath.