Pseudocroup (laryngitis subglottica)

Pseudocroup is an acute respiratory systems illness at which the mucosa is inflamed and swollen up in the area of the larynx and the vocal cords, sometimes also the tra-chea and bronchial tubes. The expression "Pseudo" croup means Krupp "more falsely" and must be distinguished by the "real" croup, a disease symptom at diphthe-ria. The larynx fissure gets very narrow by the tumescence, dyspnea can arise which triggers the typical hoarse, gruff, attack like croup cough and which can get life-threatening for the child.

A Krupp attack suddenly can appear or there exists a cold already some days with common colds and sore throats, most without a high fever. Primarily older infants suffer from pseudocroup attacks. The frequency maximum of the illness is at the age between 18 months and five years. Schoolchildren occasion-ally are also concerned. With older children it comes to life-threatening respiratory troubles more rarely since larynx and trachea are already stretched more strongly. Pseudocroup attacks appear in the fall and winter months more frequently than in the spring and summer. Seen statistically boys are concerned more frequently than girl.

Different triggers are possible as cause of the pseudocroup:

  • Viral infections: Virally conditional infections are the most frequent cause. Veins, parainfluenza viruses and RSVs belong to the causative agents.
  • Bacterial infections: Bacteria, such as staphylococci, Haemophilus influenzae type B, cause the infection rather rarely. A vaccination is also per default offered against the shoot mentioned last as of the third life month. Klebs-Loeffler bacilluses are the pathogene of the "genuine" Krupp. This illness only appears rarely. Also it is already vaccinated against within the first life months.
  • Allergies: Allergic reactions or an insect sting in the pharynx or larynx orifice can cause Krupp troubles.
  • Solid air pollutions: Air contaminants in high concentrations favor the pseudocroup attack. Chil-dren who live in smoker households are also more frequently affected by this illness.
The clinical picture appears as follows, Mostly in the evening or at night, it suddenly comes too rough, barking cough after some hours sleep. The typical cough is accompanied by dyspnea with breathing in loudly, drawly ("stridor"). The children wake up, notice the dyspnea and become anxiety. A pseudocroup attack can appear in different heaviness degrees. A light croup only speaks in hacking, dry cough and hoarseness; breathe in ("stridor") drawing the typi-cal appears at a stronger respiratory systems restriction. Eventuell ist es auch bei der Ausatmung zu hören. A beginning dyspnea has to be watched. At an extreme restric-tion "the child hardly gets air", passes danger of suffocation! Because of the hypoxia it can come to blue coloring of the face. The child is cyanotic.

A medical help in any case is necessary, you call the emergency service at a beginning dyspnea!

So that the child gets air sufficiently again you must start with the following measures immediately:

  • Keep rest! This also transfers himself to your child. Suffocation anxiety and hyperkinesia conditions still can make the attack worse in addition.
  • You already have cortisone suppositories or tablets for the emergency pre-scribed get, you give these to your child so. No side effects the cortisone has an effect mucosa going down and in the acute therapy, but can be live-saving. The effect enters suppositories only after around 30 minutes.
  • Take your child highly or they let it sit at least uprightly.
  • A muggy air makes the breathing easier for the child. Let a hot water run into the bathtub at closed window in the bathroom over the hothead. Put a cold cloth for your child around the neck (seems going down). While the water is coming in, you bring your child to the fresh air (open window, balcony) also in winter. Wrap it up to this into a blanket. A fresh air strengthens the oxygen supply. If vapor has developed in the bath, you get into the bathroom with your child and you let it breathe in the muggy air.
  • If you already have an inhaler (for example par bellboy), then you let your child inhale a sterile saline solution.
  • It is also possible to put the child in front of an open refrigerator. The cool and wet air also soothes the dyspnea.
  • If your child has calmed down again, then giving it something (water, tea) to drink something cool.
  • If the attack is over, you go with your child to the fresh air or appropriately dressed to the open window.
  • You immediately call the physician at a heavy dyspnea. If there is an acute danger of suffocation, then it will intubate or carry out a tracheotomy (trache-otomy) if necessary. Both emergency measures are, however, necessary only rarely.
Go Krupp attack come also after one to your physician. It will order you cortisone suppositories for another emergency. Lift these in the butter subject of your refrig-erator and take them along also on a journey. At an acute attack the physician has inhaled your child with a vasoconstrictive means and oxygen gives. An admission to the pediatric clinic is necessary at a heavy illness. In rare cases a blood test is carried out or a smear makes sense. If the pathogenes of a bacterial nature are, the number of leukocytes is increased considerably.

Most pseudocroup attacks go without further complications. Manchmal weitet sich die Infektion jedoch aus. An otitis media, bronchitis or lung inflammation can be the con-sequence.

Be able to preventively you reduce the frequency of the attacks, by you

  • going to fields with a less loaded air as often as possible (to the sea, moun-tains, seas).
  • not smoking in the apartment.
  • (wet cloths, Luftbefeuchter) increase the atmospheric humidity in the bedroom of the child.


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