What is the clinical spectrum of respiratory symptoms of croup?

Updated: Oct 09, 2019
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Given the wide clinical spectrum of croup, the patient's symptoms can range from minimal inspiratory stridor to severe respiratory failure. [14] In mild cases, respiratory sounds at rest are normal; however, mild expiratory wheezing may be heard. Children with more severe cases have inspiratory and expiratory stridor at rest with visible suprasternal, intercostal, and subcostal retractions. Air entry may be poor. Lethargy and agitation occur and are due to marked respiratory difficulty and, hence, causing hypoxemia and increasing hypercarbia. Respiratory arrest may occur suddenly during an episode of severe coughing. Additional warning signs of severe respiratory disease include tachypnea, tachycardia (out of proportion to fever), and hypotonia. Children unable to maintain adequate oral intake will become dehydrated. Cyanosis is a late, ominous sign.

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