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From: john@ur-tut.UUCP (John Gurian)
Newsgroups: net.med
Subject: Re: CROUP
Message-ID: <273@ur-tut.UUCP>
Date: Thu, 5-Dec-85 14:26:59 EST
Article-I.D.: ur-tut.273
Posted: Thu Dec  5 14:26:59 1985
Date-Received: Sat, 7-Dec-85 17:15:49 EST
Organization: Univ. of Rochester Computing Center
Lines: 42

> Can anyone tell me more about croup?
> How serious can this be?
> Does it usually re-occur?

Croup, or more precisely, acute laryngeo-tracheitis, is a viral infection of
the trachea and/or larynx.  The virus responsible can change from year to
year; currently, parainfluenza type I is the most common pathogen.  The virus
causes an inflammation (and therefore a narrowing) of the trachea and upper
airways.  This narrowing is responsible for the "stridor", or inspiratory
wheeze, which is characteristic of the disease.  Croup is rarely diagnosed
if the patient is older than 2 years; it appears that only the immature upper
airways of the younger child are susceptible to the amount of swelling necessary
to produce respiratory distress.  Although it can be a very serious disease if
untreated, it is usually not fatal nowadays.

	Other diseases often confused with croup are asthma and foreign object
aspiration, both of which can produce wheezes.

	Treatment: most important is keeping the child calm & inactive.  The
more the child cries, the harder it has to breathe, and the worse his/her
condition becomes.  If the condition is serious enough to warrant hospital
admission, the child will be placed in a "croup tent", in which cool mist
can be inhaled.  No one really knows why this helps so much, but it is thought
that the coolness of the mist helps to reduce the swelling of the trachea.
If the virus causing the croup is RSV (respiratory syncytial virus), ribavirin,
a new (relatively) viri-static agent can be prescribed, but RSV is rarely a
cause of croup.  Corticosteroids (eg Decamedron) may help, but should be
given judiciously since their main purpose, as far as medical Rx is concerned,
is to knock out the body's immumne system, which is not a bright idea when the
body has an infection to begin with.

Note that: 1) I am not board-certified in pediatrics, and 2) I never evaluated
or examined your child, so I would never presume to be qualified to say 
whether Decamedron was necessary here.

After one bout of croup, I don't believe a child stands a much higher risk
than anyone else does of contracting it again.  In fact, it could be less,
depending on how many serotypes of paraflu I are out there.

		John Gurian
		Univ. Rochester School of Medicine
		seismo!rochester!ur-tut!john