False croup disease

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False croup

False croup syndrome or acute stenotic laryngitis is an infectious-allergic lesion of the larynx, leading to its stenosis (narrowing) with the formation of suffocation and a threat to the patient’s life.

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False croup is an acute condition that requires immediate calling an ambulance.

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Often, symptoms of false croup occur in children from the age of one to 4-5 years; after this age, false croup syndrome practically does not occur due to anatomical features.

This condition is life-threatening, since due to edema, air access to the lungs can be almost completely blocked.

In adults, false croup is extremely rare, having mainly an acute allergic nature. This is explained by the peculiarities of the anatomy of the larynx.

This croup is called false due to the fact that, unlike true, diphthyritic croup, it does not form films that block the respiratory tract. With false croup, swelling of the tissue and stenosis of the larynx occurs.

Causes

The development of false croup is based on the viral nature of the infection. Often the development of croup usually gives:

Also, laryngeal stenosis with false croup can be caused by microbial lesions, such as:

In addition, for the development of laryngeal edema and false croup syndrome, certain conditions and predisposing factors identified in children are necessary. These include:

  • the special structure of the larynx and tracheal area in childhood (they are soft and easily compressed by surrounding tissues),
  • In children, the vocal cords are located high, they are short, and the muscles are very excitable,
  • in addition, the nervous system is still immature and the regulation of the work of reflex zones is still imperfect,
  • There is a lot of loose elastic tissue around the larynx and in its mucous membranes, prone to swelling.

Croup does not occur in all children, as in addition to anatomical factors, there are risk factors that make croup more likely. Usually this:

  • male gender (boys suffer from false croup three times more often than girls),
  • tendency to food and drug allergies,
  • birth injuries,
  • congenital stridor (narrowness of the airways) in babies,
  • high weight and paratrophy (excess weight in children under one year old),
  • period after vaccinations,
  • frequent and long-term illnesses.

Children most often get sick during the change of season, when the likelihood of developing viral and microbial infections is highest. Manifestations of false croup begin with damage to the larynx and trachea - laryngotracheitis and stenosis develop.

Laryngeal stenosis progresses quite quickly, so help for croup should be provided immediately.

Manifestations of false croup

Croup begins against the background of a cold; in the initial stage, symptoms usually appear in the evening or at night:

  • begins with a rough, dry, barking or croaking cough,
  • there may be fever, restlessness, crying, forced position,
  • rapid breathing appears, there may be shortness of breath,
  • breathing becomes noisier and deeper.

As the severity of the condition increases with degree 2 stenosis:

  • stenotic breathing occurs, audible at a distance,
  • shortness of breath develops at rest, constant, on inspiration,
  • the participation of auxiliary respiratory muscles joins,
  • children are excited, pale and restless,
  • There may be cyanosis (blue discoloration) around the mouth, especially when coughing or feeling restless.

When the condition decompensates, more severe symptoms occur:

  • circulatory and respiratory disorders,
  • a sharp increase in the work of the respiratory muscles,
  • tissue hypoxia,
  • anxiety and a feeling of fear, which turns into drowsiness and lethargy,
  • voice is very hoarse,
  • the cough gradually becomes quieter due to a sharp narrowing of the lumen of the larynx,
  • severe shortness of breath,
  • breathing is noisy and frequent,
  • chest movements are paradoxical, irregular,
  • pressure drops sharply.

If timely assistance is not provided, asphyxia occurs with coma, convulsions, weak and shallow breathing, tachycardia is replaced by slow blood circulation and cardiac arrest.

Diagnostics

The first signs of false croup are noticeable to the parents themselves. Usually the diagnosis is made by emergency doctors or emergency departments of infectious diseases hospitals.

To confirm, blood is taken for a general analysis and gas composition, but generally the diagnosis is carried out quickly - minutes count.

Treatment of false croup

First of all, the first signs of croup are a reason to call an ambulance. The treatment is carried out by infectious disease specialists and resuscitators.

  • remove all restrictive clothing from the child and calm him down as much as possible,
  • open windows or vents, provide fresh air,
  • if you have an inhaler, inhale saline solution to ease breathing,
  • if you don’t have an inhaler, breathe in the bath over the steam from hot water.
  • Give your child fluids more often,
  • give an antipyretic for severe fever,
  • If breathing stops, induce vomiting by pressing on the root of the tongue.
  • give antihistamines - fenistil, zodak, tavegil drops to slightly reduce swelling.

In the hospital, anti-edematous and anti-infective therapy is carried out:

  • injections of hormones to relieve swelling of the larynx,
  • inhalations with saline and naphthyzine to ease breathing, alkaline inhalations,
  • carrying out anti-infective treatment (antibiotics, antivirals),
  • sedative therapy to relieve the child’s fear,
  • dietary nutrition and increased drinking regimen.

In case of severe stenosis, tracheal intubation with placement of a breathing tube is indicated. And in case of asphyxia - tracheotomy with placement of a breathing tube.

Complications and prognosis

The most serious prognosis of false croup occurs with stenosis of 3-4 degrees; it can become dangerous to the life and future health of the child. In addition, stenoses tend to recur, so parents should always have an inhaler and solutions on hand at home to ease breathing and relieve swelling.

Diagnosis by symptoms

Find out your probable illnesses and which doctor you should go to.

Source: http://www.diagnos.ru/diseases/infec/lozhniy-krup

False croup

False croup is an acute inflammatory process of the larynx, accompanied by swelling of its subglottic region, which leads to stenosis of the larynx and obstruction of the upper respiratory tract. False croup is manifested by a dry “barking” cough, hoarse voice and inspiratory shortness of breath, causing noisy breathing. The severity of the condition of patients with false croup depends on the degree of laryngeal stenosis and often changes during the day. False croup is diagnosed thanks to the characteristic clinical picture and auscultatory picture in the lungs, as well as data from an CBS blood test, blood gas analysis, laryngoscopy, radiography, bacterial culture, PCR and ELISA diagnostics. Treatment of patients with false croup is carried out with antibiotics, antitussives, sedatives, antihistamines and glucocorticoids.

False croup

Stenosing laryngitis, which develops with diphtheria, is called true croup. Cases of stenosing laryngitis of other infectious etiologies are included in the concept of false croup. In otolaryngology, false croup has several synonymous names: stenosing laryngitis, acute obstructive laryngitis, subglottic laryngitis, subglottic laryngitis. False croup occurs mainly in young children. This is due to the funnel-shaped shape and small size of their larynx, and looser fiber of the subglottic region. Such anatomical features of the children's larynx contribute to the rapid development of inflammation and swelling. In adults, diphtheria (true) croup is observed mainly. Approximately half of the cases of false croup occur in children 1-3 years old. Children over 6 years of age rarely suffer from false croup; they make up only 9% of the total number of cases. The incidence of false croup is highly seasonal, with its peak occurring in late autumn and early winter.

Causes and pathogenesis of false croup

The most common cause of false croup is a viral infection. These are mainly parainfluenza viruses, influenza and adenoviruses, less commonly measles, herpes simplex, chickenpox, and whooping cough viruses. False croup of bacterial etiology (Haemophilus influenzae, streptococci, staphylococci, pneumococci) is observed quite rarely and is characterized by a more severe course. As a rule, false croup occurs as a complication of acute rhinitis, pharyngitis, adenoiditis, influenza, ARVI, measles, chicken pox, scarlet fever and other infections. False croup may be a consequence of exacerbation of chronic tonsillitis. The appearance of the disease is facilitated by the weakened state of the child’s body as a result of birth trauma, fetal hypoxia, rickets, diathesis, artificial feeding, vitamin deficiency, and reduced immunity.

False croup differs from ordinary laryngitis in that inflammatory changes in the larynx are accompanied by stenosis. Laryngeal stenosis, which accompanies false croup, develops as a result of several pathogenetic mechanisms. Firstly, inflammation of the larynx with false croup is characterized by severe swelling of the space under the vocal cords, which narrows the lumen of the larynx in this area. Secondly, a reflex spasm of the constrictor muscles of the larynx occurs, which aggravates its stenosis. Thirdly, as a result of inflammation, the secretory activity of the glands of the laryngeal mucosa increases with the formation of a large amount of thick sputum. Sputum, as well as necrotic deposits, obstruct the narrowed lumen of the larynx.

The above mechanisms cause the development of obstructive syndrome - a violation of the passage of air into the respiratory tract. At the beginning of false croup, the insufficient supply of oxygen to the body is compensated by increased work of the respiratory muscles and more intense breathing. As the degree of stenosis and obstruction increases, a stage of decompensation may occur. As a result of severe stenosis in false croup, hypoxia develops - oxygen starvation, leading to disruption in the functioning of primarily the central nervous system and cardiovascular system, as well as all organs and tissues.

Classification of false croup

Depending on the etiology, viral and bacterial false croup are distinguished. Based on the presence or absence of complications, false croup is divided into complicated and uncomplicated.

But most often in clinical practice, false croup is classified according to the degree of laryngeal stenosis. With compensated stenosis (grade I), inspiratory dyspnea (difficulty in inhaling) is observed with anxiety or physical exertion. False croup with subcompensated stenosis (II degree) is accompanied by inspiratory dyspnea not only during exercise, but also at rest. Decompensated stenosis (III degree) is characterized by severe inspiratory or mixed shortness of breath, and paradoxical breathing may be observed. In false croup with a terminal degree of stenosis (IV degree), severe hypoxia occurs, leading to the death of the patient.

Symptoms of false croup

In most cases, false croup develops on the 2-3rd day of acute infectious disease of the upper respiratory tract. A triad of symptoms typical of croup appears: a loud, barking cough, hoarseness and stridor - noisy breathing caused by a narrowing of the lumen of the larynx. Inspiratory type of shortness of breath is observed. The child is excited and restless. The degree of increase in body temperature depends on the type of pathogen and the state of reactivity of the body. This may be a low-grade fever (usually with parainfluenza infection) and a rise in temperature up to 40 ° C (mainly with the flu). Examination of a child with false croup often reveals enlarged cervical lymph nodes (lymphadenitis). When inhaling, whistling dry rales may be heard.

Clinical manifestations of false croup directly depend on the degree of laryngeal stenosis.

I degree of stenosis is characterized by the presence of shortness of breath only during physical exertion and excitement of the child. Auscultation reveals an extended inhalation and the presence of isolated wheezing in the lungs, appearing mainly on inhalation.

The second degree of stenosis is characterized by the presence of shortness of breath even at rest. On inspiration, retraction of the jugular fossa and intercostal spaces is observed. Dry rales are heard on auscultation. A bluish coloration of the nasolabial triangle appears, indicating mild oxygen starvation. Tachycardia, agitation, and sleep disturbances are noted.

III degree of stenosis. There is severe inspiratory shortness of breath with retraction of the jugular fossa, intercostal spaces and epigastric region during breathing. A patient with false croup has a pronounced “barking” cough, dysphonia and paradoxical breathing appear. Mixed shortness of breath is possible, which is an unfavorable sign in terms of the prognosis of the disease. Cyanosis is diffuse. The pulse is threadlike with prolapses on inspiration, tachycardia. The child’s anxiety gives way to lethargy, drowsiness, and confusion occurs. In the lungs, during inhalation and exhalation, dry and moist rales of various sizes are heard, and muffled heart tones are noted.

IV degree of stenosis is characterized by the absence of a “barking” cough and noisy breathing typical of false croup. Arrhythmic shallow breathing, arterial hypotension, and bradycardia are observed. Convulsions are possible. The consciousness of a patient with false croup is confused and turns into a hypoxic coma. False croup with IV degree of stenosis can be fatal due to the development of asphyxia.

A distinctive feature is that false croup occurs with changes in the severity of obstructive syndrome and inspiratory dyspnea throughout the day from pronounced to almost imperceptible. However, the greatest severity of the condition is always observed at night. It is at night that attacks of false croup occur, caused by severe stenosis of the larynx. They are manifested by a progressive feeling of suffocation, fear and motor restlessness on the part of the child, severe shortness of breath, a characteristic cough, perioral cyanosis and pallor of the rest of the skin.

Complications of false croup

Disruption of normal breathing in false croup with degree II-III stenosis leads to the addition of bacterial flora and the formation of purulent fibrinous films on the walls of the larynx. The spread of infection down the respiratory tract causes the development of acute tracheobronchitis, obstructive bronchitis and pneumonia. Complications of croup can also include sinusitis, otitis media, tonsillitis, conjunctivitis, and purulent meningitis.

Diagnosis of false croup

False croup is diagnosed by a pediatrician or otolaryngologist on the basis of a typical clinical picture, medical history (the onset of the disease against the background of a respiratory tract infection), the results of examination of the child and auscultation of the lungs. Additionally, microlaryngoscopy and culture of a throat smear are performed to identify and identify a bacterial pathogen. The identification of chlamydial and mycoplasma flora, which in some cases causes false croup, is carried out using PCR and ELISA methods. To detect a fungal infection, a smear is microscopyed and cultured on Sabouraud's medium. The severity of hypoxia, which accompanies false croup, is assessed by analyzing the ABS (acid-base state) and blood gas composition. Diagnosis of complications caused by false croup includes radiography of the lungs, pharyngoscopy, rhinoscopy, otoscopy and radiography of the paranasal sinuses.

Differential diagnosis of false croup

False croup must first be differentiated from true croup. Diphtheria croup is characterized by a gradual and progressive increase in laryngeal stenosis, accompanied by dysphonia up to complete absence of voice. False croup can occur with voice disturbances, but it never causes aphonia. True croup is characterized by a lack of amplification of the voice when crying or screaming. In patients with false croup, voice enhancement remains. Diphtheria croup can be diagnosed by identifying diphtheria deposits during examination of the larynx and detecting the causative agent of diphtheria during bacteriological examination of smears.

False croup is also differentiated from other diseases that may be accompanied by laryngeal stenosis. These are allergic edema of the larynx, foreign body of the larynx, acute epiglotitis, retropharyngeal abscess, tumor of the larynx, damage to the larynx in children with congenital syphilis, attack of bronchial asthma, congenital stridor, etc.

Treatment of false croup

The main goal of treating a child with false croup is to prevent and relieve attacks of laryngeal stenosis, relieve inflammation and swelling of the subglottic area. It is necessary to exclude the influence of factors that can provoke an attack. It is necessary to provide access to fresh air and plenty of alkaline drinks, stop taking foods that irritate the throat, if possible, give the patient with false croup medications in the form of syrups, use throat softening lozenges, aerosols and inhalations. False croup, accompanied by a nonproductive cough, is an indication for the prescription of antitussive medications (codeine, licorice root, thermopsis, oxeladine, prenoxdiazine).

Antihistamines are used (mebhydrolin, diphenhydramine, hifenadine), which have an antitussive and decongestant effect. False croup with severe laryngeal stenosis is treated with glucocorticoid drugs, sedatives and antispastic agents. Taking antibiotics is recommended from the first day of illness with bacterial false croup or if infectious complications develop. Treatment for false croup of a viral nature is carried out with antiviral drugs.

The attacks accompanying false croup are caused by a reflex spasm of the larynx and can be stopped by attempts to evoke an alternative reflex. To do this, press on the root of the tongue, provoking a gag reflex, or tickle the nose, causing a reflex sneeze. Hot foot baths, warm compresses on the larynx and chest, and cupping on the back are also used.

Prognosis for false croup

Timely diagnosed false croup has a favorable prognosis and, with adequate therapy, usually results in complete recovery. False croup, treatment of which was started in the decompensation stage, can be accompanied by severe complications and progress to the terminal stage, often ending in death.

False croup - treatment in Moscow

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Source: http://www.krasotaimedicina.ru/diseases/zabolevanija_lor/pseudocroup

False croup in children: symptoms, first aid, treatment

False croup in children is a complication of laryngitis, which is often found in young children and has many synonyms in otolaryngology - stanosing laryngitis, laryngostenosis, obstructive laryngitis. True croup occurs against the background of the infectious disease diphtheria, which, thanks to vaccination, is now practically never encountered.

Causes of false croup in children

A predisposing factor in the development of false croup in young children is the anatomical feature of the structure of the larynx - it is equipped with a huge number of blood vessels, loose fiber and has a funnel-shaped narrowed shape. The older the child, the less likely it is that he will have this complication; as a rule, laryngostenosis occurs in children 1-3 years old.

The main reason for the development of false croup in children is a progressive viral infection - inflammation of the larynx is provoked by parainfluenza, influenza, adenovirus, measles, herpes, and cytomegalovirus viruses. In most cases, false croup in children occurs as a complication of acute inflammatory diseases of the nasal cavity and oropharynx - rhinitis, ARVI, pharyngitis, tonsillitis, laryngitis.

Children at risk include those who:

  • have chronic foci of infection in the body;
  • often suffer from colds;
  • take antibiotics or other medications that suppress the immune response for a long time;
  • are on artificial feeding;
  • are prone to allergic reactions hereditarily or have a burdened allergic history.

False croup in children is the development of laryngeal stenosis, which occurs against the background of inflammation of the organ, swelling of the mucous membranes and tension in the muscles of the laryngopharynx. In addition, against the background of a progressive inflammatory process of the larynx, the activity of the glands of the mucous membranes increases, resulting in the production of a large amount of sputum. This sputum accumulates in the lumen of the respiratory tract, thereby narrowing the patency of the organ, which contributes to increased stenosis.

These factors lead to the gradual development of obstruction - disruption of the airway and insufficient air supply to its lower sections. At the initial stage of development of stenosis, the body compensates for the oxygen deficiency by increasing respiratory movements, but as the condition worsens and severe spasm of the larynx develops, oxygen starvation and decompensated conditions develop, primarily disturbances in the functioning of the heart, blood vessels and nervous system.

Classification of false croup in children by stages

Depending on the severity of laryngeal stenosis, false croup can be complicated or uncomplicated. The severity of the child’s condition is determined by the severity of laryngeal stenosis:

  • Stage 1 (compensated stenosis) – characterized by the appearance of inspiratory shortness of breath (difficulty in inhaling), which appears during physical exertion or the child’s crying;
  • Stage 2 (subcompensated stenosis) – characterized by the appearance of inspiratory shortness of breath not only during crying and exertion, but also at rest of the child;
  • Stage 3 (decompensated stenosis) – mixed shortness of breath appears with difficulty in entering and exhaling;
  • Stage 4 (terminal degree of stenosis) - characterized by the development of acute oxygen deficiency of all organs and tissues, leading to the development of heart failure, respiratory failure and death of the patient if timely assistance is not provided to him.

How does false croup manifest in children: clinical symptoms

False croup or stenosing laryngitis usually develops 2-3 days from the onset of the development of the inflammatory process in the larynx. The attack in most cases occurs in the middle of the night, the child wakes up with eyes widened in horror, breathes noisily, tries to cry, but only silently opens his mouth, his skin is pale, the nasolabial triangle is cyanotic in color. A triad of clinical symptoms of laryngeal stenosis occurs:

  • dry, loud, barking cough;
  • hoarseness of voice;
  • stridor - noisy, whistling breathing that can be heard from a distance.

Body temperature can remain within normal limits or rise to high levels. When examining a patient with false croup, the doctor reveals enlarged cervical lymph nodes, redness of the throat and dry wheezing on auscultation.

The severity of clinical symptoms directly depends on the stage of laryngeal stenosis:

  • The first is that shortness of breath appears only with crying, anxiety, or physical exertion.
  • The second is characterized by the appearance of severe shortness of breath in the baby at rest; with crying or exertion, the shortness of breath intensifies. Upon examination, retraction of the intercostal spaces during inspiration and retraction of the jugular fossa are clearly noticeable. The patient's pulse and respiratory rate increase, and the nasolabial triangle may become blue when crying.
  • Third - difficulty inhaling and exhaling appears, breathing is noisy, audible from a distance. The patient is bothered by a painful barking cough, hoarseness or complete aphonia. The pulse becomes threadlike and rapid, the skin becomes pale and cyanotic. At first the child is restless and rushes about, but gradually this state is replaced by lethargy, lethargy, drowsiness, and confusion in the child’s consciousness.
  • Fourth – barking cough and noisy breathing disappear, heart rhythm disturbances and a decrease in blood pressure appear, and convulsions are possible. As a result of the development of severe oxygen starvation and asphyxia, the child experiences death.

Possible complications

Violation of proper breathing during false croup in children of 2-3 degrees of severity leads to the activation of opportunistic flora and the addition of a secondary bacterial infection. As a result of this, fibrinous films are formed on the walls of the larynx, which contribute to the spread of the pathological process to the trachea, bronchi, bronchioles, lung tissue and the development of the following complications in the patient:

Methods for diagnosing false croup in children

Since the clinical symptoms of false and true diphtheria croup in children are extremely similar, a number of studies are carried out for the differential diagnosis of the disease:

  • a swab from the throat and nose and its subsequent inoculation on nutrient media;
  • blood and sputum tests using ELISA and PCR methods;
  • laryngoscopy;
  • X-ray of the sinuses.

If laryngostenosis in children is caused by a complication of otitis, then an additional otoscopy is performed on the child.

Diphtheria true croup is characterized by progressive stenosis of the larynx, which leads to complete loss of voice and suffocation of the patient, while with false croup the patient rarely loses his voice completely - he is often just hoarse and hoarse. With diphtheria croup, the child cries without a voice, the screams turn into hissing and bubbling in the throat, whereas with false croup, the voice remains intact when crying, only it sounds rough and hoarse.

It is extremely important to differentiate false croup from diseases such as retropharyngeal abscess, bronchial asthma, or foreign object entering the respiratory tract - treatment in these situations will differ radically.

First aid for an attack

The main principle of successful treatment of false croup in children and a favorable outcome of the pathological condition is timely relief of laryngeal stenosis. If a child wakes up in the middle of the night with a hoarse voice and difficulty breathing, then parents should immediately call an ambulance.

Before the medical team arrives, emergency care should be provided to the baby to prevent the progression of laryngeal spasm:

  • wrap your baby in a blanket and bring him to an open window or go out with him to the balcony;
  • calm the patient down, don’t panic, talk to him kindly;
  • ask your baby to breathe deeply through his nose and exhale through his mouth;
  • As a distraction procedure, the child is given hot foot baths.

If laryngitis is not uncommon in a baby and is often complicated by attacks of false croup, then the home medicine cabinet must have ampoules with Dexamethasone, Pulmicort or Berodual. The last 2 drugs are intended for inhalation administration to a child through a special device - a nebulizer. The drugs can reduce the severity of laryngeal spasm and help the child until the medical team arrives.

To stop an attack of false croup and restore full breathing, the patient is given injectable hormonal drugs - Dexamethasone, Prednisolone. The dosage is calculated by the doctor individually depending on the patient’s age and the severity of the croup. Remember that the outcome of the disease depends on how quickly, calmly and adequately parents act during an attack of false croup in a child.

To avoid recurrence of laryngeal stenosis after stopping an attack, it is important to provide the patient with cool air in the room, optimal air humidity and access to oxygen.

Treatment of false croup in children

Subsequent treatment is aimed at eliminating inflammatory processes in the larynx and conditions that cause spasm of the organ. Depending on his condition and test results, the patient is prescribed:

  • antibiotics – if laryngitis is of bacterial origin and there are complications;
  • antiviral drugs - for laryngitis of viral etiology;
  • drugs for cough relief - antitussives;
  • antihistamines - to prevent re-development of laryngeal stenosis and tissue edema.

The patient should also drink a lot of alkaline warm liquid, warm rather than hot, since the effect of heat on the throat often leads to increased blood flow and increases the risk of developing stenosis.

In difficult situations, when the baby’s life is at risk and the attack cannot be relieved with medications, doctors resort to tracheal intubation and surgery. To supply oxygen to the body, the patient is connected to a ventilator.

Source: http://bezboleznej.ru/lozhnyj-krup-u-detej

False croup: symptoms and treatment in children, first aid rules

When a viral infection affects the upper respiratory tract, a person’s voice becomes hoarse, shortness of breath and a barking cough appear, breathing becomes heavy and noisy. These symptoms are enough for a doctor to diagnose a patient with false croup. The disease mainly affects children from three months to three years.

The disease is classified as dangerous, since death is highly likely to occur if the patient is not provided with medical assistance in a timely manner. False croup occurs mainly at night. A calmly sleeping baby suddenly begins to cough. A wheezing occurs in the throat, and the child begins to choke. Such symptoms frighten parents, but this is how false croup begins in children.

False croup is a dangerous disease, so you must know first aid measures and symptoms that require you to see a doctor

What is false croup?

False croup is a very dangerous disease of the respiratory system, which occurs against the background of an acute respiratory viral infection. Young children most often suffer from manifestations of false croup. This occurs due to the anatomical and physiological features of the structure of their body:

  • The diameter of a child's larynx is only 0.5 cm. When an infection enters the respiratory system, the walls of the larynx thicken and swell. This causes the airway in the throat to shrink.
  • The body's response to infection is to produce large amounts of mucus. It also reduces the diameter of the paths through which air enters.
  • Added to all this is a reflex spasm of the laryngeal muscles, which prevents air from entering the lungs in sufficient quantities.

Attacks of false croup occur most often at night. In 90% of cases they go away on their own, but it still happens that the child urgently needs qualified medical help, otherwise irreparable things can happen. That is why, in order to avoid such situations, you need to call a doctor as soon as the first signs of false croup appear.

Narrowing of the larynx most often occurs in children aged two to four years. Sometimes six-month or one-year-old infants also suffer from this disease. In children over five years old, the incidence of false croup is not as high. This is due to the peculiarities of the development of the larynx.

Young children have a tendency to develop false croup. The reason for this is the following anatomical properties:

  • short length of vocal folds;
  • cone-shaped larynx;
  • the diameter of the cartilaginous skeleton is too small;
  • overly excitable muscles adjacent to the glottis.

The disease does not manifest itself in all children, but only in those who are included in the so-called risk group. These include children:

  • boys (they are 3 times more likely to suffer from false croup than girls);
  • with allergies to medications and food;
  • with birth injuries;
  • with congenital narrowness of the airways;
  • overweight;
  • have recently been vaccinated;
  • who get sick very often and for a long time.

In this regard, the disease has another name - stenosing laryngitis, which is accompanied by a constant narrowing of the lumen of the larynx.

Causes of the disease in children

False croup is a viral disease that occurs as a result of damage to the respiratory system. Laryngeal stenosis may be based on:

  • flu;
  • whooping cough;
  • herpes;
  • mycoplasma;
  • adenovirus;
  • scarlet fever;
  • chlamydia;
  • measles;
  • parainfluenza;
  • RS virus;
  • chicken pox.

Acute laryngotracheitis can develop against the background of scarlet fever or another viral disease

In addition to viral causes of false croup in children, there are also microbial causes. These infections include:

Medical practice has shown that for the development of laryngeal edema in a child, special conditions are required that are unique to the child’s body. This:

  • cone-shaped larynx;
  • high vocal cords;
  • rapid reaction of the laryngeal muscles to any stimuli due to a high degree of excitability;
  • the unique anatomy of the larynx and trachea, inherent only in children (due to their softness, they can be compressed by the tissues located around them);
  • short length of vocal cords;
  • immature nervous system;
  • imperfect regulation of reflexes;
  • predisposition to swelling.

The disease is much more common in boys than girls

False croup is a dangerous disease that does not occur on its own. It appears as a complication after such diseases:

Most often, the disease manifests itself in spring and autumn. It is at this time that children most often suffer from colds, which can result in the development of false croup. The fact is that caring mothers dress their children heavily in the off-season. As a result, kids sweat and catch colds.

In addition to all the above reasons why a child can become a victim of false croup, one more should be mentioned - contact with a sick baby. The disease is contagious and can be transmitted by airborne droplets. That is why a small sick patient must be isolated from other children, and all his toys, furniture and other items of use must be disinfected.

Symptoms and stages of the disease

Since this disease is a consequence of infectious diseases, mothers and fathers should pay special attention to a baby who is sick and begins to cough heavily. False croup is accompanied by the following symptoms:

  • stridor (breathing with a whistling sound);
  • state of lethargy or overexcitation;
  • labored breathing;
  • bouts of coughing that resemble barking;
  • sinking of the chest wall;
  • hoarseness in the voice.

In medicine, false croup is divided into several stages. Each of them has its own characteristics. 4 stages of croup:

  1. compensated;
  2. subcompensated;
  3. decompensated;
  4. terminal.

The first stage of false croup is characterized by overexcited behavior of the child, as a result of which he has difficulty breathing. During inhalation, sporadic wheezing occurs, a barking cough begins, and shortness of breath appears. At this stage, oxygen still enters the body in sufficient quantities.

The onset of the disease is accompanied by severe shortness of breath

The second stage (subcompensated) is characterized by noisy breathing and increased shortness of breath. The child becomes even more restless, the cough becomes rougher, and during attacks the skin becomes pale, cold sweat appears, and the skin in the mouth area turns blue. These manifestations indicate that the body is experiencing oxygen deficiency.

At the decompensated stage of croup, lethargy and lethargy become apparent in the child. Noisy breathing is replaced by quiet breathing, arrhythmia, hypercapnia, and hypoxemia appear. The pressure drops sharply, the voice becomes hoarse, and the skin becomes bluish.

The last stage of croup is terminal. The child is in critical condition. He may have seizures or develop a coma. Blood circulation slows down, which can result in asphyxia. If the child does not receive immediate medical attention, the risk of suffocation is very high.

Diagnostic methods

In order to diagnose false croup in a patient, it is enough for the doctor to:

  • review your medical history (for example, if symptoms arose as a result of ARVI);
  • conduct an objective examination (perform a visual examination, monitor blood pressure, assess breathing patterns and heart function, listen to the chest to identify wheezing dry rales).

Videoendostroscopic examination of the larynx using a rigid endoscope

To confirm the diagnosis, doctors use the laryngoscopy method, which can be used to visually assess the condition of the laryngeal mucosa. For this purpose, a special device is used - a laryngoscope. This method makes it possible to detect redness and swelling of the mucous membrane, as well as narrowing of the laryngeal lumen.

In addition to laryngoscopy, doctors use additional diagnostic methods such as:

  • microscopic examination of a smear taken from the throat;
  • bacteriological analysis of a throat smear;
  • polymer color reaction (makes it possible to detect the causative agent of the disease);
  • analysis of the acid-base state of the blood and its gas composition (helps to assess the degree of hypoxia);
  • identification of specific antibodies to identify the pathogen.

Features of treatment

First aid for a child

Croup can cause serious complications. That is why, as soon as the first symptoms of the disease appear, it is necessary:

  • call an ambulance;
  • provide the baby with an elevated position (sit him in his arms or put him on the bed);
  • calm the child;
  • ventilate the room and humidify the air in it;
  • give your baby plenty of warm drinks;
  • provide access to cold air (you can wrap up the child and go out with him to the balcony or, alternatively, bring the baby into the bathroom, in which the tap with cold (not hot!) water is open);
  • Prepare a warm foot bath for the child (for reflex vasodilation).

Following these recommendations should alleviate the patient's condition. But if this does not happen, and the doctors have not arrived yet, the child can be given:

  • antihistamine;
  • pain reliever (for example, No-shpu);
  • a drug containing salbutamol (for example, Bronchoril).

An attack of croup can be stopped by pressing on the root of the tongue. The same effect will be obtained if the baby is tickled under the nose. It is important to know that any steam procedures (for example, inhalation or rubbing) are strictly prohibited for this disease.

Hospital treatment

The main treatment for false croup in a child is carried out in a hospital setting. It consists in:

  • preventing further attacks;
  • relieving swelling;
  • combating the inflammatory process.
Therapy, which can only be prescribed by a qualified specialist, includes:
  • injections with hormonal drugs (help relieve swelling of the larynx);
  • inhalations with Naphthyzin and saline (make breathing easier);
  • anti-infective treatment (antibiotics and antiviral drugs);
  • sedatives (to calm the baby);
  • diet and drinking plenty of fluids.

For false croup, one of the methods of complex treatment is inhalation

If the stenosis occurs in a severe stage, the patient undergoes tracheal intubation with the installation of a breathing tube. In extreme cases (when suffocation occurs), a tracheotomy is performed with the installation of a breathing tube.

Therapy at home

If treatment takes place at home, then all doctor’s recommendations must be strictly followed. The patient needs:

  • provide fresh air (ventilate and humidify the room where the baby is);
  • give alkaline drinks or medications that help remove mucus from the respiratory system;
  • do not feed food that can irritate the walls of the throat;
  • give throat soothers;
  • use (strictly as prescribed by your doctor) antihistamines to relieve swelling and relieve cough;
  • in case of severe stenosis, give anti-inflammatory drugs;
  • Give antifungal and antibacterial agents in a timely manner if an infection is detected.

The child's room should always be well ventilated and humidified

Preventive actions

Preventative measures that will help prevent false croup include:

  • hardening of the throat;
  • general strengthening of the body;
  • humidifying the air in the room where the baby is;
  • compliance with hygiene rules;
  • timely treatment of colds;
  • proper nutrition (foods such as citrus fruits, chocolate, bright fruits, spices quite often cause the appearance of false croup);
  • frequent heavy drinking;
  • long walks in the fresh air;
  • avoiding contact with children with ARVI;
  • proper clothing (it must be appropriate for the season so that the baby is neither hot nor cold).

As for hardening the neck, it is done something like this: you need to take a glass, pour water at room temperature into it and let the child gargle. Gradually, the water temperature should be lowered, but this should be done slowly and carefully. Haste can lead to illness in the baby. After 2-3 months from the start of hardening, you can switch to procedures with cold water.

A friend of mine, when her daughter started having a barking cough, gave her warm milk with bear fat to drink. And you know, it helped. At 4-5 days the child is like a cucumber. There was no trace of the disease left. Their pediatrician recommended this to her. And most importantly, no drugs.

I know that badger fat is a good remedy for any problems with the respiratory system. They even treat pulmonary tuberculosis and oncology. Can it be used for false croup? And in general, can it be given to children?

Attention! All information on the site is provided for informational purposes only and is for informational purposes only. For all questions regarding the diagnosis and treatment of diseases, you must consult a doctor for an in-person consultation.

Source: http://vseprorebenka.ru/zdorove/zabolevaniya/lozhnyj-krup-u-detej.html

False croup

Sometimes it happens that a small child, due to an infectious disease of the respiratory tract, experiences involuntary difficulty breathing. The conducted research can frighten parents, because their baby is diagnosed with false croup. This pathological condition is quite dangerous, since in the absence of adequate treatment measures it can be fatal. To prevent this from happening, you should understand in more detail the causes that provoke the pathology, its symptoms and the main methods of treatment.

False croup in children: features of the disease

The disease false croup is not considered true in clinical practice. Most likely, this condition can be called a syndrome that occurs due to an infectious lesion of the larynx and is characterized by the appearance in children of hoarseness of the voice, barking, dry cough and unexpected attacks of suffocation. The disease is always associated with the development of an inflammatory process in the area of ​​the larynx, on its mucous membrane. False croup in children is characterized by the appearance of swelling in the throat, in the area of ​​the vocal cords, associated with catarrhal phenomena occurring there. The concept of this disease includes laryngitis of several types, which has an infectious etiology.

Doctors call the following types of this otolaryngeal disease false croup:

  • stenosing laryngitis. Acute inflammation of the larynx, which in severe cases can spread to the trachea and bronchi. Usually develops after a bacterial type of microorganism joins a viral infection;
  • subglottic laryngitis. The pathological process is localized directly in the subvocal space. Depends on the characteristics of the anatomical structure of the larynx in children;
  • subglottic laryngitis. The main area of ​​inflammation in this form of pathology is the subglottic region. This localization is associated with its filling not with elastic tissues, but with loose fiber, which does not give it a tight fit and makes it easier for pathogenic microorganisms to penetrate inside.

False croup in a child can occur once, but most often this pathological phenomenon is characterized by episodic bursts that are associated with the entry of any, even the most harmless, infection into the baby’s body. In clinical practice, there have been cases of repeated development of such an unpleasant and dangerous syndrome even with a common runny nose. This disease is seasonal and most often the disease strikes children in the autumn and winter, but sometimes it is diagnosed in children in the summer.

Types and types of false croup in children

The classification of this rather dangerous ENT disease in children depends on several factors and helps specialists in choosing the right treatment. False croup is of two types - bacterial and viral. This division of pathology is directly related to the nature of the origin of the disease. Also, false-type croup is usually classified according to the presence of complications into complicated and uncomplicated. But most often in clinical practice, stenotic laryngitis in children, considered false croup, is divided according to the degree of development of stenosis in the larynx:

  1. compensated. Signs of pathology are minimal, there is only inspiratory shortness of breath, characterized by difficulty in breathing. It appears only after physical activity or when the baby is very restless;
  2. subcompensated. Inspiratory dyspnea can occur in a child even when he is at rest;
  3. decompensated. Shortness of breath becomes pronounced and very severe. A baby with this type of pathological condition often experiences paradoxical breathing, in which a reverse movement of the chest occurs, that is, it increases as you exhale and decreases as you inhale;
  4. terminal. With this type of laryngeal stenosis, young patients almost always develop severe hypoxia (oxygen starvation), almost always leading to the death of the child.

As can be seen from the above classification of the disease, laryngitis with stenosis in children, called false croup in medical circles, is a very dangerous pathological condition that requires immediate medical attention.

Causes of false croup in childhood

Problems associated with pathological swelling of the larynx worry many parents, which is why it is worth understanding what causes false croup in very young children and whether it is possible to avoid the appearance of this syndrome in the baby. The main reason that provokes in babies the development of this negative syndrome of “interception” of breathing, which accompanies some ENT diseases, is the anatomical structure of their upper respiratory tract. The baby’s larynx and trachea still have an increased softness of structure, so the edematous tissues surrounding them easily press on the weak breathing tubes, thereby blocking the flow of air into the lungs.

This is the main cause of false croup in children, but there are a number of certain anatomical and physiological features that can quickly lead to an infectious disease of the larynx ending in this negative syndrome.

Experts note the following risk factors that are unique to young patients:

  • functional immaturity of some reflexogenic zones, in which the parasympathetic nervous system temporarily becomes dominant. It is responsible for slowing down physiological processes such as breathing. With age, by the age of 6 children, their maturity begins, and the threat of developing a pathological condition after any cold recedes;
  • small diameter, softness and pliability of the cartilaginous skeleton of the larynx, which contributes to its regular compression by surrounding edematous tissues;
  • its narrow lumen and funnel-shaped shape;
  • increased excitability of the muscular corset located in the immediate vicinity of the glottis;
  • excessive looseness of the mucous membrane, associated with a minimal amount of elastic fibers, which are penetrated by many blood vessels;
  • disproportionate size and high location of the vocal cords.

But not all children are susceptible to the development of a pathological condition of the larynx, although its anatomical and physiological structure is the same for all children. This factor is connected with the fact that in order for false croup to develop, the causes must be accompanied by a number of negative features. They increase the likelihood of swelling in the larynx area, which is dangerous for a small child.

The main risk factors that provoke the occurrence of a pathological syndrome are considered to be the presence of a baby’s tendency to allergic reactions, trauma suffered during birth or paratrophy (excess weight of the baby associated with improper feeding).

False croup: symptoms and manifestations in children

The disease begins against the background of a cold, usually on the 2-3rd day of an acute inflammatory process in the larynx. The initial stage of this pathological syndrome, which occurs with the development of swelling in the upper respiratory tract, is characterized by the appearance of the main symptoms in the evening or at night. When false croup begins in young children, the symptoms are quite mild, but any parent should know them. This will make it possible to promptly notice the development of the disease and contact a specialist for emergency medical help, which can save the baby’s life.

The first alarming signs indicating the onset of a pathological process in the larynx are:

  • dry and rough cough of a croaking or barking nature;
  • shortness of breath due to the inability to take a normal breath;
  • shallow, noisy and very rapid breathing.

This triad of signs is the most characteristic of false croup. It is from this that one can promptly suspect the development of the disease. In addition to specific manifestations, you should pay attention to general symptoms. As leading otolaryngologists note, it consists in the fact that a sick child becomes restless and whiny, often taking a forced body position in which negative symptoms are not so strongly felt. Experts also note that in some cases there may be fever and an increase in body temperature up to 40 ° C. Clinical manifestations of this pathology directly depend on the stage of development of laryngeal stenosis in a particular clinical case.

Their characteristics can be seen in the table:

The symptoms of false croup listed in the table in children arise and progress when therapeutic and preventive measures are ignored or serious errors are made in their implementation. If parents are attentive to the health of the baby and notice the appearance of any abnormalities in it, such a development of events, ending in death for the baby, can be completely avoided. All that is needed for this is to promptly treat colds, as well as laryngotracheitis and pharyngitis, which can provoke an attack of false croup in the baby. You should also remember the first alarming symptoms indicating the onset of a pathological condition. This will make it possible to promptly call a doctor and take emergency measures to save the child’s life.

Diagnosis of false croup

Identifying a negative phenomenon affecting the glottis area does not pose any problem for an experienced specialist. In order to detect swelling in a child’s throat, the doctor only needs to conduct an initial visual examination of the throat using a laryngoscope based on the patient’s symptomatic complaints. Laryngeal stenosis has a very characteristic clinical picture, which makes it easier to detect. The only difficulty is that it comes in 2 forms, to get rid of which completely different treatment methods are used. That is why parents often ask the question of how to identify false croup in a child without confusing it with another disease.

Otolaryngologists explain that this requires differential diagnosis. Only with its help can one exclude the more dangerous true form of the disease, the development of which is provoked by diphtheria. All studies must be carried out very quickly, since in these pathological conditions associated with laryngeal edema, minutes count.

Diagnosis of false croup in children is performed using the following methods:

  • microscopic and bacteriological examination of a throat smear, including bioculture and PCR (polymerase chain reaction), which makes it possible to most accurately identify the pathogenic causative agent of the disease and its sensitivity to antibiotics;
  • ELISA (enzyme-linked immunosorbent assay). Makes it possible to identify the pathogen by detecting specific antibodies in the biomaterial;
  • study of the acid-base state and gas composition of the blood, helping to identify the level of redox reactions in the body and the ratio of oxygen and carbon dioxide content in it. These tests are necessary to assess the degree of hypoxia (oxygen starvation).

Of the instrumental research methods in the differential diagnosis of laryngeal stenosis, farinogo- and laryngoscopy are used. In the event that a specialist suspects the development of complications, the small patient undergoes rhinoscopy, otoscopy and radiography. Treatment of false croup in children can be prescribed only after the doctor has received all test results and confirmed the diagnosis.

How and with what to treat false croup in children: medications, medications, inhalations

The main therapeutic goal in this pathological condition is to relieve laryngeal stenosis, as well as eliminate swelling and inflammation from its mucous surface. If a child is diagnosed with false croup, treatment should be prescribed by a qualified physician and carried out under his direct supervision. In addition to the use of certain therapeutic measures that can completely stop the disease, doctors advise completely eliminating the influence of negative factors that provoke an attack on the body.

Important! What to do if a child has false croup. All therapeutic measures for this disease should be prescribed to children only by a qualified doctor. Any self-medication can lead to tragic consequences, so if you notice the first signs of alarming symptoms in your baby, you must call an ambulance.

First aid for false croup in children consists of the following activities:

  • calm down a frightened child. Any negative emotions, screaming and crying will only aggravate the serious condition and cause new spasms;
  • provide free access to fresh air. To do this, open the windows in warm weather, and in cold weather a window will suffice;
  • Give the baby any warm drink with a liquid temperature in the range of 38-40 °C. It can be this or juice diluted with water. If the baby cannot drink on his own, you should feed him with a spoon;
  • give the child an age-appropriate dosage of any antiallergic antihistamine, for example Claritin, Suprastin or Tavegil;
  • make hot baths for your hands and feet, ensuring blood flow from the throat and inhalation with a soda solution (a teaspoon of soda per liter of water).

Such emergency care for false croup in children should be known to all parents, since thanks to it it is possible to prevent the onset of asphyxia before the doctors arrive. After the baby is admitted to the hospital and the doctor confirms the diagnosis, he will be prescribed a course of treatment.

Features of drug therapy

Important! If the doctors who come to the call recommend placing the child in a hospital, under no circumstances should you refuse. In most cases, effective treatment of this pathology is only possible in a hospital setting.

Therapeutic measures are prescribed to each child individually and depend on the diagnostic results, which help to determine the degree of development of the pathology. There are also general prescriptions for severe laryngeal stenosis. In no case should we forget that the listed medications should not be used independently, without consulting a doctor, as this can lead to serious consequences, and even provoke death in the child:

  • glucocorticoids. Doctors almost always prescribe Pulmicort. For false croup in children, it is considered very effective and is administered rectally, by injection or orally;
  • antispasmodics. No-shpa helps children best, which comes first in the doctor’s prescriptions;
  • antihistamines. In this group of drugs, preference is given to Diphenhydramine, Suprastin or Fenistil;
  • sedatives, sedatives. The most harmless among them is considered to be valerian extract, which is prescribed to children;
  • inhalations for false croup are carried out with humidified, medical oxygen.

If the pathology is of a bacterial nature, and infectious complications develop against its background, antibacterial drugs are prescribed without fail, and in case of a viral one, antiviral drugs are prescribed. False croup is also treated with bronchodilators. It is also necessary to take into account how cough syndrome is relieved in this disease. Here, with an unproductive, dry and barking cough, preference is given to antitussive drugs, and if there is abundant sputum in the larynx, specialists prescribe intravenous administration of calcium gluconate.

When the above course of conservative therapy is unsuccessful, they resort to surgical intervention, which involves tracheostomy (dissection of the trachea) or intubation (insertion of a special tube into the larynx to facilitate air access).

Treatment of false croup in children at home: traditional medicine recipes

Many parents are concerned about the question of whether, with such a pathological condition, it is possible to carry out therapeutic measures at home without going to the hospital for this. For the most part, the answer from otolaryngologists is negative, since an acute attack of false croup in children

stops only in stationary conditions. But if the pathological condition occurs in a child for the first time, and is not accompanied by pronounced symptoms or any complications, such a therapeutic approach is quite acceptable.

Komarovsky, a recognized pediatrician and famous TV presenter, also considers it possible to treat false croup in children at home. But, as he notes, only after the necessary diagnostic studies have been carried out and the doctor has prescribed an appropriate course of medication. Traditional medicine recipes are not only effective, but also safe, as they do not cause addiction and the development of serious consequences. Despite this, they cannot be used as monotherapy for childhood laryngeal stenosis.

Treatment of false croup at home using folk remedies is only permissible in combination with traditional medications. Only such therapy can be effective in stopping the pathological phenomenon.

The following medicinal potions prepared according to folk recipes can provide effective help with false croup in children:

  • Peppermint infusion is intended for sprinkling the baby's throat. To prepare it, you need to pour 250 ml of boiling water into a tablespoon of chopped herbs. The product is infused in a glass jar covered with a towel for half an hour, after which it is filtered and used to irrigate the baby’s neck after each meal;
  • A decoction of herbal tea treats inflammation and swelling of the pharynx from the inside. Mix the composition from 1 part each of crushed licorice root, coltsfoot leaves and plantain. A teaspoon of the prepared composition is placed in a small bowl, poured with a glass of boiling water and kept for 20 minutes in a water bath. Drink this decoction warm, 100 ml three times a day.

The given recipes effectively help in treatment, but they cannot be used if false croup occurs in children under one year of age. We should also not forget that achieving positive results with the help of these means is possible only in the initial stages of the development of the pathological condition.

Consequences of the disease

With timely diagnosis of the disease and an adequate course of therapy, the prognosis will be positive, which cannot be said about completely ignoring the inflammatory process. In this case, the consequences of false croup can be disastrous.

After pathogenic bacterial microflora joins the inflammatory process occurring in the area of ​​the glottis, a purulent film begins to form in the larynx.

Against this background, the following complications of false croup arise:

All of them pose a direct threat not only to the health, but also to the life of the baby. In order to prevent such a development of the situation, it is necessary not only to take all measures for the timely detection and treatment of the pathological condition, but also to prevent it.

Prevention of false croup in children and adolescents

When a small child has a tendency to catch colds, he has a tendency to regular relapses of laryngeal stenosis. Mothers of such babies need to have a humidity tester, a humidifier and an inhaler at home. They will help to promptly prevent the development of another attack in the baby. Also, parents of children at risk for developing this pathological syndrome should know what measures should be taken to prevent its occurrence.

Prevention of false croup in children is as follows:

  • the child’s adherence to a daily routine that allows sufficient time for sleep;
  • mandatory hardening of the baby, which includes walking barefoot, contrast showers and other general strengthening activities;
  • proper nutrition. Children should eat foods that contain sufficient quantities of vital microelements, minerals and vitamins;
  • preventing the development of viral diseases. To achieve this goal, it is enough not to visit crowded places. This advice becomes especially relevant during mass epidemics.

To strengthen the baby's throat, some parents give him small pieces of ice to suck. But it should not be ordinary, but therapeutic. Getting this kind of ice is not difficult at all. It is enough to freeze decoctions of those herbs that have an anti-inflammatory effect, such as calendula, sage or chamomile.

By following all these recommendations, it is possible to prevent the occurrence of a pathological condition even in those children who are prone to its development. The above preventive measures must be closely followed until the child is five years old, since in children 4-5 years old such pathology of the larynx occurs in exceptional cases. This is due to the age-related increase in the trachea, and at the same time its lumen.

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Comments and reviews for “False croup”

Timely diagnosed false croup has a favorable prognosis and, with adequate therapy, usually results in complete recovery. False croup, treatment of which was started in the decompensation stage, can be accompanied by severe complications and progress to the terminal stage, often ending in death.

Source: http://lor-24.ru/gorlo/lozhnyj-krup.html