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 a true croup is, how to distinguish it from a 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. Any infectious disease of the respiratory system, both acute and chronic, is a fertile ground for the development of croup. 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 in acute respiratory viral infections. Because of it, a rather extensive area of the respiratory system suffers - the inflammation spreads to the area of the vocal cords, and to the trachea, and to the bronchi.
With true croup, only the vocal cords are affected. Usually, a true croup develops against the background of a foreign small object or particles of pus, dead epithelium with inflammation in the upper respiratory tract, entering the vocal cords area.
Viral croup usually does not lead to death from suffocation, since it has an amazing ability to self-regulate. However, other types of the disease are not as harmless.
True croup is also called diphtheria, since it is this complication that most often occurs with this infection. In this case, the glottis is not only narrowed, but also 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 barking cough, hoarseness. The area of the vocal cords is the bottleneck of a child's respiratory system. The inflammatory process in this particular area cannot go unnoticed.
Against the background of a high temperature with stenosis of the larynx, difficulty breathing may develop, as well as characteristic wheezing that is heard in the minutes when the child is crying, and also sometimes in a calm state.
The deterioration of the child's condition is indicated by such signs as profuse and incessant salivation, severe shortness of breath, blue skin in the area of the nasolabial triangle.
In the second or third stages of the croup, the child can inhale a much smaller volume of air than at the zero or first stage, asthma attacks, loss of consciousness, and oxygen starvation of the brain can be observed.
With true croup, the child's condition will vary in stages, since the disease itself develops in strict accordance with certain stages. After the acute stage comes the stenotic stage. If the child has not been helped, this stage turns into asphyxia.
Shortness of breath with developing true croup is of a special nature - severely difficult inhalation and almost unobstructed exhalation.
With diphtheria croup, a child most often has fever, high fever, and severe intoxication. A special diphtheria plaque appears in the throat, similar to a grayish tight and dense film. The tonsils are also covered with it.
Even if a viral or allergic false croup begins with the same symptoms, significant differences in condition will appear on the second day. With true croup, there will be no nocturnal attacks and sudden sharp breathing difficulties. In any case, until it develops to an asphyxia stage.
The defeat of the vocal cords with true croup progresses up to the complete loss of the ability to speak. At the same time, the child begins to cry and cough completely silently. He can't even scream. With a false croup, this 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 proceed very rapidly, and in no case should you hesitate to see a doctor.
Diagnostics
Diagnostics is carried out by a pediatrician, together with an ENT specialist and an infectious disease specialist, if we are talking about true croup. Larynx radiography can tell a lot to specialists. By 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 identified by an X-ray. The leading sign of the disease is the narrowing of the larynx, which in the picture has a wedge-like appearance.
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 a diphtheria filmy plaque.
However, a bacteriological examination of a smear from the pharynx allows to establish a diagnosis with one hundred percent accuracy. If a diphtheria bacillus is found in it, then the doctor will not hesitate to formulate the diagnosis "true croup".
If there is a suspicion of diphtheria, children are usually immediately hospitalized, therefore, all the above diagnostic measures, the child will undergo already in the hospital.
Causes
True croup is never allergic. This is what distinguishes it from spastic croup (an extremely dangerous and poorly studied disease), as well as from a fairly common false croup. The main reason for the occurrence of true croup lies in the diphtheria bacillus, which causes such an unpleasant disease as diphtheria.
Doctors can find a foreign body in a child with a true croup in the area of the vocal folds, at the narrowest point of the respiratory system.
Treatment
True croup is not treated at home, it is too dangerous a disease that can lead to suffocation. All children with such a diagnosis should be hospitalized in an infectious diseases hospital.
For the treatment of the disease, anti-diphtheria serum is used, obtained from the blood of horses, which were previously hypersensitized with a diphtheria bacillus. A strong allergic reaction can occur to serum, which is why the child must be under constant medical supervision.
In case of severe difficulty in breathing, prescribe "Prednisolone" intravenously (in droppers). In addition, drip infusions of solutions are carried out, which reduce the level of intoxication and poisoning with the metabolic products of the diphtheria bacillus, the most dangerous of which is exotoxin.
For the throat, in parallel with the introduction of serum, some antiseptics are prescribed. When a bacterial infection is attached, antibiotics of the penicillin series or antimicrobial drugs of the cephalosporin group are prescribed.
If it is impossible to breathe on their own, a tracheostomy operation is performed - a 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 assistance was provided correctly and in a timely manner. These complications include pneumonia, otitis media, meningitis.
Failure to provide assistance or ignore the symptoms of croup can result in death due to 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 something (and they even cannot cry). Therefore, after calling an ambulance, it is important to calm the child down, set him up for good. Excessive worries and experiences only increase the need for a deep breath, namely, it is impossible to do it at the stenosing stage.
It is necessary to provide peace, lay the child in a horizontal position.
It is recommended to open all windows in the house, if it is cold outside, you need to dress the child warmer. Fresh air is essential.
The child should be given a warm drink before the arrival of doctors. If he is nauseous, it is difficult for him to swallow, you can drink drip - from a disposable syringe without a needle or from a teaspoon (in small portions).
You shouldn't give your child any medication. Neither cough medicine 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 in breathing, you can give an antihistamine in an age-specific dosage - for example, Suprastin. It will temporarily reduce swelling and allow you to wait for the arrival of health workers.
Prevention
Prevention of true croup is closely related to the prevention of diphtheria. All children are given mandatory calendar vaccinations against this dangerous disease.
Vaccination does not provide one hundred percent protection, however, children who have been vaccinated, if infected, suffer from diphtheria to a milder degree. It usually does not reach the development of true croup.
Parents should not refuse such vaccinations as ADKS or ADS, since these vaccines contain a diphtheria component. The first vaccination is usually given for babies at the age of 3 months. Then two vaccinations are given at intervals of 2 months. The fourth - a year after the third. Revaccination - at 6 and 14 years old.
Adults need to be careful that the child does not play with small objects that he can inhale. They may remain in the fold next to the vocal cords.
At the first sign of hoarseness and difficulty breathing, an ambulance should be calledwithout waiting for other symptoms of true croup to appear. By phone, the dispatcher should be sure to inform about his suspicions of a 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.
For what croup is and how to treat it, see the next video.
