False croup

False croup / pseudocroup / acute obstructive laryngitis

Parents can easily be confused by the terms pseudocroup or false croup, since the word ”croup” was previously mostly associated with the diphteric croup – a far more dreaded and serious condition than the normal and common pseudocroup/false croup that this small review will cover.


False croup is a virus infection commonly affecting children from apprx 3months – 3years of age. Many of the children are usually affected during late fall/early winter.


Different types of respiratory viruses, usually a type that is called parainfluenzavirus is the main pathogens. The virus initially infects the nose and upper respiratory tract, which then spreads downwards towards the larynx and trachea (the voice box and windpipe that continues to the lungs). The walls of the larynx and trachea get swollen, inflamed and oedematous.


Common cold symptoms such as cough, throat pain, hoarseness . Mild fever can also develop later on. The child has usually symptoms during the night which may awaken the child; dyspnoe, a typical barking cough and inspiratory stridor – the classic sign of pseudocroup.


Try to keep calm around the baby, as unnecessary stress can provoke symptoms. Keep the child upright as it might decrease the oedema in the respiratory tract. Cold air effectively reduces the symptoms and can even cure the child. You can for example wrap the child in many blankets and sit close to an open window, or simply take a walk if the child is fit for that.
In apprx 80% of the cases the infection will resolve itself and there is no need for further treatment.


However, if the child suddenly gets worse with higher fever, swollowng and breathing difficulties then the right thing to do is to go to the doctor! A type of drug called glucocorticoids (+/- adrenaline) will be prescribed which will effectively open up the airways.