Pseudo croup
Synonyms in a broader sense
Medical:
- Acute laryngitis
- acute laryngitis
English: acute laryngitis
definition
Pseudocroup is a laryngitis with larynx pain, which usually arises as an additional infection with inflammation of the nose, sinus infections and throat infections.
Small children are particularly often affected when the virus infection causes swelling in the area of the larynx tissue and causes typical signs of the disease (symptoms) "barking" cough, hoarseness and shortness of breath
Pseudo croup attack
In connection with the clinical picture of the Subglottic laryngitis, the pseudo croup, the so-called pseudo croup is mentioned again and again. Depending on the author and the specific wording used by the pediatrician, the term should either describe the overall event - or “only” a particularly severe breathless attack. The symptomatic overall picture of the pseudocouple includes a very characteristic cough, severe hoarseness, which can sometimes even make speaking impossible, and shortness of breath.
All symptoms set in very suddenly and especially at night. But also a more spastic Pseudo croup, which is due to a hyperreaction to certain Allergens (e.g. cat hair, house dust mites) can trigger attacks, will lead to sudden episodes with severe shortness of breath in the affected children. Pseudo croup attacks usually occur at night, because during this period the body's own cortisone production reaches its minimum, i.e. there is a poorer reaction to inflammatory stimuli; the inflammation that ultimately triggers the seizure can "break through" because it is natural Immune defense is worse.
causes
What triggers a pseudo croup?
Recurring infections in the area of the nosethroat-Room (Pharyngitis), runny nose (rhinitis), sinusitis (sinusitis), Tonsillitis (Tonsillitis)
favor the inflammation of the nearby larynx. It is usually a virus infection of the mucous membrane under the epiglottis (= subglottic space). The viruses come from the group of cold viruses (adeno-, rhinoviruses). In some cases there is an additional bacterial infection (superinfection) with a haemophilus influenza germ (HiB).
Symptoms
Barking cough, shortness of breath, especially when breathing in (inspiratory stridor), a slight fever and the hoarseness of the children characterize the pseudo croup.
The shortness of breath in the children leads to visible retraction of the skin and muscles on the chest and above the sternum.
The shortness of breath can be so exhausting for small children that they become increasingly exhausted and an acute lack of oxygen sets in. The onset of symptoms is typical after the child has been put to bed. The children then suffer from loud, barking coughs and shortness of breath.
Parents must immediately react when the child no longer reacts to them, is pale or blue, or is even unconscious. The symptoms usually subside during the day and reappear the following night.
Read more on the topic
- Difficulty breathing in children
- Laryngitis in the child
- Cough in child
to cough
The cough is next to that hoarseness, fever, possibly too sniff and Exhaustion a symptom of the pseudocouple.
The mostly dry inflammation of the larynx gives the cough its typical characteristics: it is called barking, drier or rougher to cough described.
If the cough occurs unexpectedly from sleep in the form of a minute-long attack, this attack can increase to breathlessness.
Due to the specific hormone constellation at night time (especially low in cortisol) the mucous membrane over the vocal folds swells in one Laryngitis more than during the day, as the inflammation cannot be adequately controlled.
The glottis becomes narrower and can hinder the natural rhythm of breathing.
In this case, a pseudo croup attack occurs.
Through the Irritation of the mucous membranes In the larynx and the narrow gap associated with it, the air is pressed through the glottis with great force and effort during exhalation.This at least partially explains the origin of the coughing sound.
On the other hand, when you breathe in, you get a whistling noise called a stridor. This noise can also be attributed to the narrowing of the glottis.
As a rule, the croup and with it the cough will subside after about 1-3 days.
In order to reduce the cough to a minimum during this time, it is advisable to pay attention to a few circumstances:
The apartment, especially the bedroom, should be ventilated regularly, especially before bed, so that it is cool fresh air is in the room and can extract dry heating air if necessary.
Furthermore, the patient can use to soothe the airways essential oils or chamomile inhale, place a humidifier in the room or simply put a bowl of water on the heater and drink a lot.
fever
Since most pseudo croup attacks are caused by a viral infection that causes the Mucous membrane inflamed in the mouth and throat area, causing it to swell, fever is not uncommon in affected children. Younger children in particular often react relatively early to a wide variety of pathogens with a rise in temperature. Fever can therefore appear as an accompanying symptom of the previous illness, but does not necessarily have to be noticed in a pseudo croup. With a very high fever, on the other hand, caution is advised: paediatricians, but of course also affected parents, should then also think of the so-called supraglottic laryngitis, epiglottitis, which is due to an almost extensive vaccination against its pathogen (Haemophilus influenzae) now very rare has become, but is potentially fatal. This requires the immediate intervention of an experienced pediatrician.
diagnosis
Based on 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 speak clearly for a pseudo croup.
Additionally, the doctor will do the lung wiretap for deeper infections such as a bronchitis or lung infection to exclude.
An ENT doctor would also look at the vocal folds with a larynx mirror and possibly notice a slight reddening and swelling.
In children with high fever if the doctor suspects a bacterial one Inflammation of the epiglottis (epiglottitis). In this case, the child would be taken to the hospital accompanied by a doctor, as there would be a life-threatening risk of suffocation. Since the introduction of the Haemophilus influenza vaccination (HiB vaccination), this disease has become rather rare.
therapy
In the case of slight progress, the child's body quickly makes a speedy recovery. Medication may be required. anti-inflammatory suppositories (Corticosteroids = cortisonee.g. Rectodelt ®) given to decongestant measures.
In the case of a bacterial superinfection, an antibiotic administered.
Once the child has been admitted to the hospital, they will receive oxygen at regular intervals and will remain under close supervision. If the airways swell so much that it would cause life-threatening shortness of breath, will adrenaline given with an inhaler to break the swelling.
If this treatment is unsuccessful, an intubation (breathing tube) through the nose is carried out with plastic tubes that are gentle on the mucous membrane.
Risk of contagion
The reason for a pseudo croup attack in the child is in most cases a viral infection. Like most other viruses, this can of course also be transmitted. In most cases, these are viruses that are passed on via droplet infections, for example when sneezing or coughing. However, it cannot of course be assumed that every child with a viral upper respiratory infection will develop pseudo croup. Around 10-15% of children of the same age experience a viral pseudo croup attack at least once after infection. In general, there is no direct risk of infection in pseudo croup, as the triggering event is the inflammation of the throat with swelling of the mucous membranes, which cannot be passed on.
Only the viruses (much less often bacteria) that could trigger the inflammation and then the pseudo croup in the second step can be transmitted. Since certain environmental factors also contribute to the development of the clinical picture (passive smoking of children in smoker families, heavy air pollution in the ambient air, etc.), children whose siblings have noticed with pseudo croup often also suffer a pseudo croup at some point in time. The same also applies if an accumulation of respiratory diseases (especially those with an allergic cause) is known in the family; in these cases it is relatively likely that the sibling has a similar predisposition and thus a higher risk of pseudo-picking. Affected parents should also seek advice from their pediatrician.
Read more on the topic: Pseudo Croup Contagious and Laryngitis - How Contagious Is It?
Duration
A pseudo croup attack is usually only of short duration and self-limiting. Most children experience relief very quickly after adequate initial measures. The parents of the affected child should first and foremost remain calm themselves and try to take the child's fear away for the entire duration of the attack. In panic or with strong and / or loud screaming is that Oxygen consumption of the child is significantly increased, which of course further increases the symptoms of respiratory distress. Fixed rules of thumb or forms of calculation for the duration of a pseudo croup do not exist and also not make sense.
Depending on the severity and the initial care measures taken by the parents (Was the child able to calm down well? Are there any suppositories containing cortisone in the house? Was there a fever at the beginning? A croup passes faster or more slowly Adrenaline aerosol for inhalation) to limit the duration and the Pseudo croup to finish quickly. However, medical intervention to limit the pseudo croup attack is often not necessary at all. If parents are unsure about how to proceed or the severity of the seizure, one is advisable Emergency doctor consult, who can then decide whether it is appropriate to monitor the child in the hospital and / or to administer further medication.
prophylaxis
Basically, all colds like to cough, sniff, Sinus infection and Tonsillitis can also promote infection of the larynx.
Allergies and asthma also seem to be closely related to the occurrence of pseudo croup.
The avoidance of colds, a sanitation of chronically infected tonsils (chronic tonsillitis), an operation of Polyps (Nasal polyps) make the recurrence of pseudo croup less likely.
Despite everything, the pseudo croup generally tends to appear more than once. For all concerns, however, it is easy to treat and serious consequences are rare with early treatment.
Why are children more likely to be affected by pseudo croup?
The narrow anatomical relationships of the child's airways hardly allow infectious swelling of the mucous membranes. This quickly leads to narrowing of the airways, shortness of breath and the risk of suffocation.
Pseudo croup in the baby
The classic age of onset for croup includes toddlers in old age between 6 months and about 3 years. Even younger infants, older children, adolescents and adults are affected significantly less often. Of course, a pseudo croup is not impossible in individual cases and, with typical symptoms, cannot be ruled out even at a different age. The reason for the frequent occurrence in this particular phase of life lies in the anatomical features the airways. In babies and toddlers, these are still relatively small in diameter, so that the flow of air can be significantly impeded as soon as the mucous membrane swells. Slight swelling of the mucous membranes is still quite uncomfortable in adulthood, but rarely leads to symptoms of shortness of breath.
How should parents act?
With the symptoms of "barking" cough, hoarseness and shortness of breath, the Pediatrician (Specialist in pediatrics). In some cases, the pediatrician will recommend hospitalization to ensure that the airways are kept clear and that there is adequate oxygen supply.
In any case, with all the excitement, parents should for one Reassurance and Relaxation worry of the child!
If parents panic themselves, the child will notice and the discomfort can get worse. The Room airthat the child is in should be dry and cool. Warm, moist air or even inhalation steam can irritate the sensitive larynx mucosa and worsen shortness of breath.
An early vaccination against Haemophilus influenza (HiB) should be ensured so that there is no bacterial superinfection.
