Diagnosis

On the basis of the medical history (anamnesis) the doctor can make a diagnosis quickly and without unpleasant additional examinations. “Barking” cough, a previous cold, hoarseness and worsening of symptoms after going to bed clearly indicate a pseudocroup. In addition, the doctor will listen to the lungs to rule out deeper-seated infections such as bronchitis or pneumonia.

An ENT physician would also look at the vocal folds by means of a laryngeal mirror and possibly detect a slight redness and swelling. In children with high fever, the doctor suspects bacterial inflammation of the epiglottis (epiglottitis). In this case, the child would be taken to hospital accompanied by a doctor, as there would be a life-threatening danger of suffocation. However, this disease has become rather rare since the introduction of hemophilus influenza vaccination (HiB vaccination).

Therapy

With easy progressions, the child’s body is able to recover quickly. If necessary, anti-inflammatory suppositories (corticosteroids = cortisone, e.g. Rectodelt ®) are given to reduce swelling. In the case of a bacterial superinfection, an antibiotic is administered additionally.

Once the child has been admitted as an inpatient, he or she will receive oxygen at regular intervals and remain under close supervision. If the airways swell to such an extent that life-threatening shortness of breath would result, adrenaline is administered with an inhaler and the swelling is broken down. If this treatment is not successful, an intubation (breathing tube) is performed via the nose using plastic tubes that are gentle on the mucous membranes.

Risk of infection

The reason for a pseudocrupp attack of the child is in most cases a viral infection. This is of course transmissible like most other viruses. In most cases these are viruses that are passed on via droplet infections, for example when sneezing or coughing.

Nevertheless, it is of course not to be assumed that every child with a viral infection of the upper respiratory tract will develop a pseudocroup. Approximately 10-15% of children of the appropriate age experience a viral croup attack at least once after infection. In general, therefore, there is no direct risk of infection with pseudocroup per se, since the triggering event is the inflammation of the throat with swelling of the mucous membranes, which cannot be passed on.

Only the viruses (much more rarely also bacteria), which could trigger the inflammation and then in the second step the croup, can be transmitted. Since certain environmental factors also contribute to the development of the disease (passive smoking of children in smoking families, strong air pollution of the ambient air, etc. ), children whose siblings have been diagnosed with pseudocroup often also suffer a pseudocroup attack at some time. The same also applies if a familial history of respiratory diseases (especially those with allergic causes) is known; in these cases it is relatively likely that the sibling has a similar predisposition and thus a higher risk of croup. Affected parents should also consult their pediatrician about this.