Question Diphtheria of the pharynx: localized and widespread forms. Clinic. True croup, its differential diagnosis with false croup. Croup in children: symptoms, treatment What disease is characterized by the development of true croup?

Croup is a common respiratory disease characterized by inflammation of the upper respiratory tract. This pathology causes swelling of the trachea and larynx, as a result of which the patient experiences difficulty and rapid breathing, a characteristic whistle is heard when inhaling and a characteristic croupy (barking) cough occurs. Often croup, symptoms of which are more common in children preschool age, in adult patients are diagnosed as laryngitis.

Mostly croup occurs in children under the age of 4-6 years. This is caused, first of all, by the anatomical features of the structure of the upper respiratory tract. In older children, the airways are wider, the cartilage in the walls is less elastic, and during inflammation, the effect of swelling of the mucous membrane is not so critical and significant. Parents who first notice symptoms of croup in their child often panic. Don't be scared - you should immediately go to a pediatrician or doctor general practice. Timely diagnosis- deposit successful treatment.

Croup: pathogenesis

Croup occurs with various inflammatory diseases respiratory system, changes in the area vocal cords and subglottic space. When interviewed, patients often complain about barking cough, and the patient’s voice is hoarse and hoarse. Changes in the tissues of the respiratory tract, swelling of the laryngeal mucosa, lead to a narrowing and deterioration of the lumen, while the air flow accelerates, which causes rapid breathing, drying of the mucous membrane and the formation of a crust, which further reduces the lumen of the larynx. It becomes difficult for the child to breathe and then the auxiliary muscles turn on chest, which upon visual inspection looks like a protrusion. Due to this, an extended inhalation occurs through a narrowed, inflamed larynx, the pause between inhalation and exhalation increases, and breathing is accompanied by a characteristic noise (stenotic breathing). In this way, the lack of oxygen is partially compensated and the necessary gas exchange in the lungs is maintained. But, despite this, the minute volume of oxygen in the lungs still decreases, even as the degree of stenosis of the larynx increases, part of the blood in the pulmonary sac is not oxygenated and is discharged into the arterial circulatory system great circle. This condition ultimately leads to arterial hypoxia, and then to hypoxemia. The latter should be regarded as the beginning of decompensation of pulmonary function. It is important to understand that the greater the narrowing of the larynx, the more pronounced the hypoxia will be, which has a detrimental effect on all organs and systems. Hypoxemia causes tissue hypoxia, and later - severe disorders of cellular metabolism with pronounced changes in the cardiovascular, central nervous, neuroendocrine, and other vital systems of the human body.

It is also worth considering that in addition to the mechanical factor in the pathogenesis of croup in acute respiratory diseases, the main role is played by a reflex spasm of the laryngeal muscles, which is characterized by increased stenotic breathing, up to asphyxia. When a child has croup, the psychosomatic condition- anxiety arises, the baby is very capricious and has a feeling of fear. For this reason, the use of sedatives in complex therapy croup, in this case there is an improvement in the child’s breathing.

Separately, it is worth noting that the accumulation of thick bacterial mucus in the vocal cavity, the formation of crusts and necrotic and fibrinous deposits leads to the occurrence of purulent laryngotracheobronchitis and laryngitis. The analysis often reveals streptococcus, staphylococcus, and other gram-negative flora.

Predisposing factors include previous paratrophy, childhood eczema, drug allergies, birth injuries, frequent acute respiratory diseases of the respiratory tract.

Classification of croup

In otolaryngology, there are concepts of true and false croup. The latter has a bacterial or viral etiology. False croup is classified according to the degree of pathology of the respiratory system, changes in the mucous membrane of the larynx:

I degree - with compensated stenosis;
II degree - with subcompensated stenosis;
III degree - with decompensated stenosis;
IV degree - in terminal stage stenosis

True croup moves sequentially from one stage to another. Based on this, we can distinguish: catarrhal (dystrophic) stage of the disease, asphyxial and stenotic stages of croup.

Causes of croup

Croup occurs due to swelling of the mucous membrane, swelling of the trachea and larynx. This pathology of the respiratory system is often caused by other common respiratory diseases (ARVI or influenza). Also, croup symptoms often appear during allergic reactions to various irritants and seasonal natural phenomena. Less commonly, croup is a complication of diphtheria.

Often croup develops due to infectious lesion cartilage (epiglottis), which blocks the entrance to the larynx when swallowing saliva. The child experiences general changes in his physical condition: weakness, increased body temperature, painful swallowing, dry mouth, etc.

Symptoms of croup

The child has a characteristic barking cough and whistling sounds when entering and exhaling air. When coughing, the face acquires a reddish tint from the tension that the patient experiences when coughing and expectorating accumulated bacterial mucus. It is worth paying attention to the complexion; if the color is paler than usual, and the lips have a bluish tint, this means that the child is not only having difficulty breathing, but the body is not receiving the required amount of oxygen. With such indicators, immediate hospitalization of the child in a specialized hospital is recommended. A high temperature may indicate severe croup infectious nature, for example, diphtheria or epiglotitis. How quickly a child gets into the hands of doctors will determine his health, and sometimes his life.

Various pathologies of the upper respiratory tract and, as a consequence, narrowing of the walls of the lumen of the larynx lead to breathing problems. The air flow increases, so-called shortness of breath appears, which is accompanied by retraction of the jugular fossa and intercostal spaces. The pectoral muscles participate incorrectly in the respiratory process: when inhaling, the chest decreases, and when exhaling, it expands. Too active breathing leads to drying of the mucous membrane and the formation of a crust. Thus, an even greater narrowing of the lumen of the larynx appears, breathing is extremely difficult, and a characteristic whistle is heard. With abundant accumulation of mucus in the lumen of the larynx, the vocal cords wheeze and the voice is hoarse. The variability of breathing sounds indicates the dominance of spastic components of obstruction. A decrease in the intensity of breathing noise may indicate worsening stenosis.

Diagnosis of croup

The symptoms of croup resemble any respiratory infection upper respiratory tract. Croup is diagnosed by three identified symptoms: difficulty breathing, a deepened voice and a rough, barking cough. Taking into account big picture Diagnosis of the disease is not difficult for a doctor. There is a whole group of diseases of the respiratory system that the doctor needs to exclude, but often one disease causes all the symptoms of croup. A pediatrician or otolaryngologist can diagnose the disease. Depending on the course and stage of inflammation of the laryngeal mucosa, laryngoscopy may be necessary. A pulse oximeter is used to determine the level of oxygen in the blood. For bronchopulmonary infectious complications You will need to be examined by a pulmonologist. If there is syphilis, then croup is diagnosed together with a venereologist. For tuberculosis patients, you will need to consult a phthisiatrician.

After other pathologies have been excluded and a final diagnosis of croup has been established, treatment is prescribed in accordance with the overall clinical picture. At the last examination, rough wheezing with a characteristic whistle is heard in the lungs. Wheezing signals an exacerbation of the disease. Since bacterial mucus collects in the larynx, it will be necessary to take a smear for bacteriological culture to verify the pathogen. You will need to conduct PCR tests, RIF and ELISA studies. Laryngoscopy data will help to find out the degree of narrowing of the walls of the larynx, the inflammatory process, and detect fibrinous films characteristic of diphtheria. Complications require additional studies: otoscopy, lumbar puncture, pharyngoscopy, rhinoscopy, paranasal sinuses and pulmonary radiography.

True and false croup: differential diagnosis

If a patient has an established diagnosis of croup, symptoms and treatment depend on the clinical picture of the disease. False croup is diagnosed only with diphtheria and is accompanied by inflammation in the vocal cords. In false croup, inflammation affects, in addition to the vocal cords, the mucous membrane of the larynx, trachea, and even the bronchi. False croup is diagnosed for all other respiratory tract diseases (acute respiratory infections, parainfluenza, influenza, etc.), except for diphtheria.

The main symptoms of true croup of diphtheria etiology are a barking cough, O hoarse voice, difficulty in inhaling and exhaling - stenotic breathing. Similar symptoms of croup develop progressively over 4-5 days. Afterwards, the hoarse voice gives way to aphonia, and the barking, rough cough becomes silent. With appropriate treatment, a gradual elimination of symptoms is observed: the stenosis decreases and disappears completely, the cough disappears, and the voice is completely restored.

The first manifestations of false croup appear suddenly and often also disappear suddenly. This form of pathology is initially characterized by sudden stenosis during sleep in the daytime or at night. True croup ends in stenosis, and as a consequence, asphyxia. With isolated true croup, general specific intoxication is not clearly expressed, the course of the disease depends on the nature of hypoxia.

With influenza, symptoms of croup appear in the first 1-2 days of the disease, or already during a second wave of the disease. Croup due to influenza can vary: from light form to extremely severe.

At the first manifestations of croup, there is often an increase in temperature of about 39°, runny nose, severe chest cough, symptoms of intoxication (lethargy, fatigue, headache, drowsiness, in case of complications - convulsions, disturbance of consciousness).

Treatment of croup

If true diphtheria croup is diagnosed, patients are immediately hospitalized. Treatment is carried out in combination with antispastic, antihistamine and sedatives. Drug treatment is prescribed in accordance with the performance indicators diagnostic studies, bacteriological culture and others diagnostic measures. The effectiveness of treatment directly depends on the stage at which the disease is developing. It is customary to prescribe intravenous or intramuscular injection anti-diphtheria serum. Detoxification therapy is practiced - drip administration of glucose and various sorbents; prednisolone is used as prescribed by a doctor.

Depending on the type of cough the patient has, the following are used: antitussives (oxeladine, glaucine, codeine, etc.) - for a dry cough, mucolytics (acetylcysteine, carbocysteine, ambroxol) - for a wet, expectorant cough with copious sputum.

For severe laryngeal stenosis, your doctor may prescribe glucocorticosteroids. If croup is of an acute viral infectious nature, appropriate antiviral drugs. Treatment with antibiotics is necessary to prevent secondary bacterial infection of the patient. For symptoms of hypoxia, oxygen therapy is applicable, and treatment is carried out with inhalations.

Prevention of croup

To prevent true diphtheria croup, babies at the age of three months are vaccinated. False croup does not imply any preventive measures. The most important thing is to provide the baby with a healthy immune system. Specifically for children with weakened immune system All conceivable and inconceivable diseases “stick” to us. Proper nutrition, which includes all the necessary nutrients, regular walks and sleep, health and hardening procedures - these are far from full list activities that help maintain the baby’s immunity at the desired level. Love your baby, seek medical help in a timely manner and all illnesses will bypass you!

Croup is a rather dangerous disease of the respiratory system, which occurs as a complication of acute infectious and inflammatory processes in the respiratory organs. Due to some anatomical and physiological features child's body most susceptible to development of this disease Small children.

The main danger of croup for the patient’s health is the increasing respiratory distress, which appears due to narrowing of the larynx and upper sections trachea. Therefore, this disease has another name - stenotic (that is, accompanied by a persistent narrowing of the lumen of the organ) or laryngotracheitis.

There are two types of croup:

True. It develops only with diphtheria. The pathology is based on specific fibrinous inflammation with the formation of films on the mucous membrane of the larynx (in the area vocal folds). A person's airways become clogged with these films, and suffocation occurs.

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False. It is a complication of other infectious and inflammatory diseases of the respiratory system. Obstruction of the respiratory tract with this type of croup occurs mainly due to swelling of the walls of the larynx (and the same vocal folds).

False croup is the most common, so it will be the main focus of this article.

Depending on the prevailing pathological changes False croup can occur in various forms:

in edema, in which serious condition the patient is caused by swelling of the respiratory tract;
in hypersecretory, characterized by abundant formation of viscous sputum, blocking the lumen of the larynx;
in spasmodic, caused by spasm of the respiratory system;
in mixed, in which several pathological manifestations are present at once (edema and hypersecretion, edema and spasm, etc.).

Causes of croup

Croup in a child can occur due to the following infectious diseases:

and - in most cases.
Illnesses caused by respiratory syncytial virus and.
Inflammatory diseases of the respiratory system of bacterial nature.

Why do children most often develop croup?

Children aged 6 months and older are most susceptible to developing false croup. up to 3 years; in older age, this syndrome is much less common. This pattern is explained by some anatomical and physiological features of the child’s respiratory tract:

What happens in the respiratory tract during croup?

An acute inflammatory process in the larynx is usually accompanied by swelling of the mucous membrane and the formation of mucus. If this swelling is pronounced (especially in the narrowest place of the larynx - in the area of the vocal folds and under them), the lumen is partially blocked at first, and with increasing pathological changes - to a critical level, as a result of which the patient cannot inhale normally and suffocates. This is croup. A significant accumulation of sputum and spasm of the laryngeal muscles contribute to the obstruction of the airways in this disease. Moreover, it is very important that the child’s anxiety, screaming and crying only intensify the spasm of the respiratory system.

The likelihood of developing croup is especially high at night. This is explained by the following physiological phenomena: when a child lies for a long time, the outflow of blood and lymph from the tissues occurs somewhat differently (therefore, swelling increases), the drainage activity of the respiratory tract decreases (mucus accumulates in them). If there is also dry, warm air in the room, which dries out the mucous membranes, the risk of respiratory disorders increases significantly.

Croup is characterized by a triad of symptoms:

barking paroxysmal cough;
stridor (noisy breathing), especially when the child cries or is agitated;
hoarseness of voice.

In addition, there appear secondary signs illness - severe anxiety, rapid breathing and heartbeat, nausea, hyperthermia.

Increasingly respiratory failure all symptoms worsen, the child’s skin becomes gray or bluish, salivation increases, wheezing becomes audible even when calm, and anxiety is replaced by lethargy.

Diagnosis of croup

Croup in a child is diagnosed based on characteristic clinical picture and the presence of symptoms of an infectious-inflammatory disease of the respiratory organs. Carry out some additional research V similar situations there is simply no time, since assistance to the patient must be provided immediately.

Others may have symptoms similar to croup. pathological conditions: foreign body aspiration (for example, inhalation of parts of toys), allergic swelling of the respiratory tract, laryngeal injuries, sudden laryngospasm, epiglottitis and others. The approach to the treatment of these ailments is somewhat different, so it is impossible to independently treat a child who has manifestations of airway obstruction.

First aid for croup

The first thing parents should do when their child develops symptoms of croup is to call ambulance. Next, do the following (before the doctors arrive, you can try to alleviate the baby’s condition):

Take the child in your arms and calm him down. As mentioned above, fear and anxiety lead to increased spasm of the respiratory tract.
Wrap the patient in a blanket and bring him to open window or take it out onto the balcony (it needs access to cold air). You can also bring your child into the bathroom, which has a tap with cool water (not hot!) on.
If there is a nebulizer in the house, let the child breathe in saline solution or mineral water.

Important! Any steam inhalations, rubbing and other similar procedures are contraindicated for croup.

Treatment of croup

Children with symptoms of croup should be hospitalized. The first thing doctors must do is restore the airway. To do this, it is necessary to reduce swelling and spasm of the larynx, as well as free its lumen from accumulated mucus. Therefore on prehospital stage, and then in a hospital setting the patient is given the following treatment:

If ineffective conservative therapy tracheal intubation or tracheotomy is performed followed by artificial ventilation lungs.

Since false croup most often occurs in children against the background of croup, its development can be prevented by preventing “colds”. Besides, important role The correct behavior of parents when dealing with influenza and other similar ailments in a child plays a role in preventing the occurrence of stenosing laryngitis. It is the implementation of the doctor’s recommendations, the creation of comfortable conditions in the patient’s room (clean, moist, cool air), drinking plenty of fluids, regular nasal rinsing, and not advertised medications, can reduce the severity of pathological changes in the respiratory organs.

In addition, during acute respiratory infections it is not advisable to do the following: apply mustard plasters, rub the patient with means essential oils, give your baby citrus fruits, honey and other potential allergens. All this can cause a reflex spasm of the laryngeal muscles and provoke the development of croup.

Important: Parents of children who have had croup before should definitely consult with their pediatrician about how to behave if the child develops the first threatening symptoms of respiratory disorders, and what medications for emergency assistance must be in your home medicine cabinet.

Zubkova Olga Sergeevna, medical observer, epidemiologist

There are diseases that pose a certain danger to life, but they are dangerous only in childhood. One of these ailments is croup. After reading this article, you will learn what true croup is, how to distinguish it from false croup, what are the symptoms and treatment.

What it is?

Croup in children is a disease of the respiratory system. With it, an inflammatory process develops in the respiratory organs, which is complicated by stenosis (narrowing) of the larynx. Fertile ground for the development of croup is any infectious disease of the respiratory system - both acute and chronic. At risk are children from 3 months to 3 years. At this age, the airways are already narrow, so any inflammation can cause stenosis.

False croup usually develops with acute respiratory viral infections. Because of it, a fairly large area of the respiratory system suffers - inflammation spreads to the vocal cords, trachea, and bronchi.

In true croup, only the vocal cords are affected. Typically, true croup develops against the background of a foreign small object or particles of pus or dead epithelium entering the area of the vocal cords during inflammation in the upper respiratory tract.

Viral croup usually does not lead to death from suffocation, since it has amazing ability self-regulate. However, other types of the disease are not so harmless.

True croup is also called diphtheria, since this is the complication that most often occurs with this infection. In this case, the glottis not only narrows, but also becomes covered with diphtheria plaque.

Symptoms

Symptoms of true croup usually develop (as well as signs of false croup) on the second or third day after the onset of the underlying disease. The first (and most obvious) signs are a barking cough and hoarseness. The vocal cord area is the bottleneck in a child's respiratory system. Inflammatory process It is in this area that it cannot go unnoticed.

Against the background of high temperature, with laryngeal stenosis, difficulty breathing may develop, as well as characteristic wheezing, which is heard when the child is crying, and also sometimes in a calm state.

Signs such as profuse and incessant drooling, severe shortness of breath, and blue discoloration indicate that the child’s condition is deteriorating. skin in the area of the nasolabial triangle.

In the second or third stages of croup, the child may inhale a significantly smaller volume of air than at the zero or first stage; attacks of suffocation, loss of consciousness, oxygen starvation brain

With true croup, the child’s condition will change in stages, since the disease itself develops in strict accordance with certain stages. After the acute stage, the stenotic stage begins. If the child has not received help, this stage becomes asphyxial.

Shortness of breath with developing true croup has a special character - very difficult inhalation and almost undifficulty exhaling.

With diphtheria croup, the child most often experiences fever, heat, severe intoxication. A special diphtheria coating appears in the throat, similar to a grayish tight and dense film. The tonsils are also covered with it.

Even if viral or allergic false croup begins with the same symptoms, significant differences in the condition will appear on the second day. With true croup, there will be no night attacks or sudden, severe difficulty breathing. In any case, until it develops to the asphyxial stage.

Damage to the vocal cords in true croup progresses up to total loss opportunity to speak. At the same time, the child begins to cry and cough completely silently. He can't even scream. With false croup, such a symptom never occurs. The voice becomes hoarse, but does not completely disappear.

All symptoms in a child develop much faster than in an adult. Sometimes they occur very quickly, and under no circumstances should you hesitate to see a doctor.

Diagnostics

The diagnosis is carried out by a pediatrician together with an ENT specialist and an infectious disease specialist, if we are talking about true croup. X-rays of the larynx can tell specialists a lot. Based on the degree of narrowing, doctors will be able to judge the stage of the disease. If there are foreign objects in the throat, this can also be immediately determined by x-ray. The leading sign of the disease is considered to be a narrowing of the larynx, which in the picture has a wedge-like appearance.

Laryngeal stenosis

To clarify the diagnosis, laryngoscopy is prescribed. With true croup, it shows significant changes in the mucous membranes of the vocal cords and larynx, as well as the presence of diphtheria membranous plaque.

However, it is possible to establish a diagnosis with one hundred percent accuracy bacteriological examination throat swab. If a diphtheria bacillus is detected in it, then the doctor will not hesitate to formulate a diagnosis of “true croup”.

Laryngoscopy

If there is a suspicion of diphtheria, children are usually immediately hospitalized, so the child will undergo all the diagnostic measures described above in the hospital.

Causes

True croup is not allergic. This is what distinguishes it from spastic croup (an extremely dangerous and little-studied disease), as well as from the fairly common false croup. main reason the origin of true croup lies in the diphtheria bacillus, which causes such an unpleasant disease as diphtheria.

Doctors may detect that a child with true croup foreign body in the area of the vocal folds, in the narrowest place of the respiratory system.

Treatment

True croup cannot be treated at home; it is too dangerous a disease that can lead to suffocation. All children with this diagnosis should be hospitalized in an inpatient infectious diseases hospital.

To treat the disease, anti-diphtheria serum is used, obtained from the blood of horses that have previously been hypersensitized with diphtheria bacillus. The serum may experience strong allergic reaction, which is why the child must be under constant medical supervision.

If there is severe difficulty breathing, Prednisolone is prescribed intravenously (in droppers). In addition, they carry out drip infusions solutions that reduce the level of intoxication and poisoning by diphtheria bacillus waste products, the most dangerous of which is exotoxin.

For the throat, in parallel with the administration of serum, some antiseptics are prescribed. Upon joining bacterial infection antibiotics are prescribed penicillin series or antimicrobials group of cephalosporins.

If it is impossible to breathe on your own, a tracheostomy operation is performed - dissection of the trachea to create a reserve path for air that enters the lungs.

Complications

Such a dangerous syndrome quite often gives complications, even if medical care was provided correctly and in a timely manner. Such complications include pneumonia, otitis media, and meningitis.

If help is not provided or symptoms are ignored, croup may occur. death associated with suffocation.

First aid

The transition from the catarrhal stage of true croup to loss of voice often causes panic in children, because they cannot say anything (and they cannot even cry). Therefore, after calling an ambulance, it is important to calm the child down and set him up for the good. Extra worries and worries only increase the need for deep breath, namely, it cannot be done at the stenotic stage.

You should not give your child any medications. Neither cough suppressants nor antibiotics can help if you develop diphtheria croup. The introduction of a special serum is required, which is exactly what awaits the child in a hospital setting. In case of severe difficulty breathing, it can be given in an age-appropriate dosage antihistamine– for example, “Suprastin”. It will temporarily reduce swelling and allow you to wait for paramedics to arrive.

Prevention

Prevention of true croup is closely related to the prevention of diphtheria. From this dangerous disease All children receive mandatory vaccinations.

Vaccination does not provide 100% protection, but children who have been vaccinated suffer from milder diphtheria if they become infected. The development of true croup usually does not occur.

At the first signs of hoarseness and difficulty breathing, you should call an ambulance without waiting for other symptoms of true croup to appear. By telephone, you should definitely inform the dispatcher about your suspicions of true croup; this will significantly speed up the arrival of a team of doctors with special equipment that will allow them to deliver the child to the hospital alive.

To learn what croup is and how to treat it, watch the following video.

True croup (diphtheria) is an acute inflammation of the larynx. It occurs during diphtheria and poses a serious danger in case of untimely treatment, since it is accompanied by swelling of the mucous membrane and stenosis (narrowing) of the airway in the area of the vocal cords, which can lead to asphyxia. Children are more likely to get croup early age(up to five years) due to the special structure of the respiratory organs and, consequently, greater vulnerability.

Symptoms and signs

The main sign that makes it possible to make a correct diagnosis and differentiate true from false croup is the formation of fibrinous films on the surface of the mucous membrane of the larynx.

In development of this disease Three stages with characteristic features can be distinguished.

Catarrhal lasting from several hours to three days, in which the following are observed:

a sharp rise in temperature to 38°C;
weakness, fatigue;
loss of appetite;
swelling of the larynx with the formation of fibrinous films;
specific When sputum accumulates, the cough becomes bubbling;
hoarseness of the patient's voice.

Stenotic(can also last from several hours to 3 days). This stage is characterized by:

When the stenotic stage transitions to the asphyxic stage, the patient experiences a feeling of fear and danger.

The skin in the area of the nasolabial triangle becomes bluish due to lack of oxygen (hypoxia).

Asphyxial:

breathing becomes much less noisy, but becomes more frequent, intermittent and arrhythmic;
the nasolabial triangle turns blue (cyanosis), and if the patient’s condition worsens, the fingers and toes turn blue;
pressure drops;
consciousness is disturbed, convulsions appear.

In case of failure to provide necessary assistance asphyxia develops and death occurs.

The course of the disease in adults and children has some differences.

By virtue of anatomical features(narrow funnel-shaped larynx, massive loose mucous membrane), children are characterized by very rapid development of all stages (within several hours), with a sharp rise in temperature.

In adults, sometimes the only symptom inflammation of the laryngeal mucosa causes hoarseness. In most cases, when inhaling, there is no retraction of the jugular and subclavian fossa.

Causes

True croup is a syndrome that occurs due to diphtheria (), the causative agent of which is Lefler's bacillus.

Treatment methods

The main condition for successful treatment is urgent hospitalization of the patient. The following activities are carried out in a hospital setting:

Treatment with folk remedies such a dangerous disease, especially in children, when the disease develops rapidly, is completely unacceptable.

At home, while waiting for the ambulance to arrive, it is possible to take certain actions to alleviate the manifestations of the disease:

warm alkaline drink;
placing mustard plasters on the calves and top part chest to drain blood from affected organs and reduce swelling;
steam inhalations with soda, aminophylline, herbs (expectorants);
intramuscular injection of prednisolone.

Possible complications

Prognosis for recovery with timely hospitalization early stages the course of the disease is favorable. In the absence of qualified medical care Possible death.

True croup can be complicated by various inflammatory processes:

pneumonia;
otitis;
bronchitis;
meningitis;
sinusitis.

Read about the symptoms and treatment methods for false croup on the page.

Preventive measures

Prevention of this disease is mass routine vaccination of children from three months of age.

Thanks to the immunization of the population with the anti-diphtheria vaccine, cases of diphtheria croup are reported infrequently. However, even timely vaccination cannot provide a 100% guarantee. Therefore, it is necessary to know the main symptoms of the disease in order to recognize it in time in case of illness and seek qualified help.

You can find out how false croup differs from true croup while watching the video.

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Croup (stenosing laryngitis )
Croup in Scots means " croak" This is a disease that consists of acute inflammation respiratory organs ( most of all the larynx), which occurs with a hoarse and loud cough, difficulty breathing, and hoarseness of the voice. Croup is a disease caused by pathogenic microbes that attack the respiratory system. Croup happens true as, for example, with diphtheria, and also false (for other ailments affecting the larynx). In adults, croup practically does not develop.

What is croup?

This is an acute ailment that manifests itself in inflammation, as well as swelling of the laryngeal mucosa, which develops under the influence of infection of the respiratory system by pathogenic microbes. It rarely happens that the infection spreads exclusively to the larynx. Most often, both the trachea and bronchi are involved in the disease.

Why does croup develop?

Diseases such as parainfluenza, influenza, adenovirus, diphtheria, and scarlet fever can cause croup. In this case, croup differs between false and true. Only croup in diphtheria is considered true. With this form of croup, the mucous membranes of the vocal cords are involved in the process. Croup is called false croup, which develops in all other diseases of the respiratory system, and most often this disease involves the mucous membranes of the trachea, which are located below the vocal cords.

Main signs of croup

The main signs of croup are:
Stridor– when breathing, a whistle, extraneous gurgling sounds are heard, the patient is breathing heavily. In this case, the degree of extraneous noise during breathing indicates the degree of laryngeal edema. If the noises become louder, it means that the swelling is increasing and the patient needs emergency care doctors.

"Barking" nonproductive cough – it usually appears a little earlier than stridor.

Deepening of the voice- this is one of the symptoms of croup only in cases where, along with coarsening, the above-described signs are also present. If only hoarseness is observed, then this is most likely a symptom of laryngitis, in which the larynx usually does not swell.

Most often, croup appears in the presence of ARVI (acute respiratory viral infection) and in this regard, in addition to the previously stated signs, the patient also experiences an increase in body temperature, a change in behavior, discomfort in the muscles and joints, as well as other signs of a cold. The appearance of signs of croup during a common cold is a signal to call a doctor. A child with croup should be supervised at all times and receive proper treatment. In this regard, if a child develops croup, you need to monitor his condition almost all the time and not leave him alone.

Causes of croup in children

Most often, croup is observed in children - preschoolers. Fewer cases of croup are observed in children after six years of age and in babies under six months of age.
The appearance of croup in preschool children is due to the fact that they still have a fairly narrow gap in the larynx and trachea, as well as under the mucous membrane there is a thick layer of soft connective fibers, which very quickly form edema. In addition, the nerve endings of the respiratory organs are very sensitive, which creates favorable conditions for development laryngospasm (contraction of the laryngeal muscles).

What ailments should not be confused with croup?

It has already been said that false croup most often develops in acute respiratory diseases. But there are diseases whose symptoms resemble croup.

Diphtheria occurs with true croup. In the case of diphtheria, the patient's health slowly becomes worse and becomes very poor. In addition, with this disease, thick tissue is deposited on the tonsils. white coating. Diphtheria is a disease that can be fatal. In this regard, if symptoms resemble diphtheria, the baby should be immediately sent to the hospital.

Allergic swelling of the larynx- appears suddenly ( in a couple of minutes) and occurs only with symptoms of croup, in the absence of other signs of acute respiratory diseases. If signs indicate allergic swelling of the larynx, you should immediately call an ambulance. As first aid a pill may work Claritin or suprastin sublingually.

Hit foreign object into the larynx– in addition to signs of suffocation, there is also a profuse spasmodic cough.

Laryngospasm- appears most often in children of the first and second year of life as one of the signs of rickets. Laryngospasm is characterized by sudden blueness of the face, suffocation, and the patient begins to scream in a very high-pitched voice. As urgent assistance You can press the back of the tongue with a spoon to induce vomiting or splash cold water on the baby’s face.

Therapy for croup

Therapy for croup and acute laryngitis consists of the following measures:
If signs of croup appear, you should immediately call an ambulance. If the baby’s well-being does not deteriorate and there is no croup, you can do without an ambulance.

Until the ambulance arrives, the baby should be kept in conditions close to a tropical climate: the air temperature is up to eighteen degrees, but the humidity needs to be high. If it is impossible to create such conditions, you can simply bring the patient into the shower room from time to time so that he can breathe in the steam from the hot water flowing from the tap.

If the child's temperature increases to more than thirty-eight and a half degrees, you need to use medicines to lower it.

If there is a nebulizer in the house, it is good to fill it with saline solution and place it in the room where the patient is. If you don’t have a nebulizer, you need to inhale with heated salt water.

The baby should drink more warm tea.

If your baby develops croup or laryngitis, you should consult a pediatrician who will prescribe medications for the treatment of a disease.