Materiały źródłowe

• #1 Croup – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431070/

  Croup accounts for 7% of hospitalizations in children younger than five years of age. […] Croup affects about 3% of children per year, typically between the ages of 6 months and three years. […] Parainfluenza virus accounts for more than 75% of croup infections. […] It is more common in boys than girls with a 1.5:1 ratio. […] Approximately 85% of cases are defined as mild croup, and less than 1% are considered severe croup.

• #2 Croup: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0501/p575.html

  Croup is a common respiratory illness affecting 3% of children six months to three years of age. It accounts for 7% of hospitalizations annually for fever and/or acute respiratory illness in children younger than five years. […] Croup is typically self-limited in immuno-competent children, occurring predominantly during the fall and winter. It is more common in boys than in girls (1.5:1 ratio). Although the incidence of croup is highest between six months and three years of age, it can occur in children up to six years of age, or earlier than six months in atypical cases. […] Less than 5% of all children with croup are hospitalized, and of those only 1% to 3% require intubation. […] In patients with recurrent croup (more than two episodes per year), clinically significant bronchoscopy findings are associated with risk factors such as prior intubation, prematurity, and age younger than three years. […] Outcomes are favorable; croup has a mortality rate of less than 0.5%, even for intubated patients.

• #3 Croup: Symptoms and Treatment | Doctor

  https://patient.info/doctor/croup-pro

  Croup affects about 3% of children per year, mostly between the ages of 6 months and 3 years. Hospital admissions due to croup peak in September to December, but occur throughout the year. Annually, 7% of hospitalisations in children in the USA are due to croup. […] The type of infectious agent does not affect outcomes or initial management. […] The diagnosis is usually made on clinical grounds but the following investigations may be indicated: Once in hospital, blood tests and chest x-ray are not usually required as they are usually of little clinical value and risk distressing the child and making the symptoms worse.

• #4 Croup: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/962972-overview

  Croup is the most common pediatric illness that causes acute stridor, accounting for approximately 15% of annual clinic and emergency department visits for pediatric respiratory tract infections. Croup is primarily a disease of infants and toddlers. […] The disease occurs most often in late fall and early winter, but may present at any time of the year. Approximately 5% of children will experience more than one episode. […] The male-to-female ratio for croup is approximately 1.4:1. […] Primarily a disease of infants and toddlers, croup has a peak incidence in patients from age 6 months to 3 years. In North America, incidence peaks during the second year of life, at 5-6 cases per 100 children. Although uncommon after age 6 years, croup may be diagnosed in the preteen and adolescent years and, rarely in adults.

• #5 Croup – Wikipedia

  https://en.wikipedia.org/wiki/Croup

  Croup affects about 15% of children, and usually presents between the ages of 6 months and 56 years. It accounts for about 5% of hospital admissions in this population. In rare cases, it may occur in children as young as 3 months and as old as 15 years. Males are affected 50% more frequently than are females, and there is an increased prevalence in autumn. […] Many cases of croup are preventable by immunization for influenza and diphtheria. […] Croup is a relatively common condition that affects about 15% of children at some point. It most commonly occurs between six months and five years of age but may rarely be seen in children as old as fifteen. […] Before vaccination, croup was frequently caused by diphtheria and was often fatal. This cause is now very rare in the Western world due to the success of the diphtheria vaccine.

• #6 Croup: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0501/p1067.html

  Croup is more common in boys than in girls, usually occurs between six and 36 months of age, and peaks during the second year of life. It has been reported occasionally in adolescents and rarely in adults. The incidence of croup often peaks during the fall season, although sporadic cases may occur throughout the year. […] Croup is a common illness responsible for up to 15 percent of emergency department visits due to respiratory disease in children in the United States.

• #7 Croup | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/croup?embed_domain=staging.radpair.comfavicon.icofavicon.icoradiopaedia-icon-144.png&lang=us

  Croup can happen in children as young as 6 months up to 15 years old, but most commonly between 6 months to 3 years with a peak at 18 months. It is the most common cause of upper respiratory distress in infants and young children which usually occurs in late fall to early winter. […] Although imaging findings are not required for the diagnosis, classic findings of narrowing of the subglottic airway and dilatation of the hypopharynx are supportive of the diagnosis.

• #8 Croup (Laryngotracheobronchitis) | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617648/all/Croup__Laryngotracheobronchitis_?q=Adenovirus

  Accounts for 35% of total visits to the emergency department (ED) […] Most commonly occurs in children between 6 and 36 months of age […] Although cases can be seen up to 6 years of age, it is uncommon in children 6 years. […] Mean age at presentation is 18 months. […] Most prevalent in the fall to early winter […] Major peak in October with parainfluenza type 1, with minor peaks later during respiratory syncytial virus (RSV) and influenza season […] ED visits for croup are most frequent between the hours of 10 p.m. and 4 a.m. […] More common in males (ratio 1.4:1)

• #9 Croup epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Croup_epidemiology_and_demographics

  Annually, the incidence of croup is approximately 532/100,000 individuals, peaking in the fall of each year. Croup is primarily found in children between 6 months and 6 years of age, but rare cases have been reported in children as young as 3 months and as old as 15 years. Males are 1.5 times more likely to develop croup. Croup is found more often in developing countries due to the larger proportion of children in the populations, as well as the higher proportion of malnutrition and vitamin deficiency. […] On an annual basis, the incidence of croup is approximately 532/100,000 individuals, 3% of children under 5 years old worldwide. […] Cases of croup usually peak in the fall on an annual basis from human parainfluenza virus serotype 2 and biannually from human parainfluenza virus serotype 1.

• #10 Acute management of croup in the emergency department | Canadian Paediatric Society

  https://cps.ca/documents/position/acute-management-of-croup

  Croup is one of the most common causes of upper airway obstruction in young children. […] Croup accounts for significant rates of ED visits and hospitalizations in Canada, with one population-based study in Alberta reporting that 3.2% to 5.1% of all ED visits in children 2 years of age were related to croup. […] Less than 6% of children presenting to ED with croup symptoms require hospitalization and when they are admitted, it is usually for a short stay. […] There is considerable variation in clinical practice for croup.

• #11 Croup: diagnosis and management – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/croup-diagnosis-and-management

  Croup, also known as laryngotracheobronchitis, is a common respiratory disease involving cough, stridor (i.e. creaking, whistling or grating sounds caused by irregular airflow), hoarseness and varying degrees of breathing difficulty. It is a sign of airway obstruction caused by generalised inflammation. […] Croup typically occurs in children aged between 6 months and 3 years, peaking at the age of 2 years; it is uncommon after the age of 6 years. It tends to affect males more than females (1.4:1) and there is no evidence to suggest variations in ethnicity prevalence. […] Caused by several respiratory tract viruses, croup is most commonly caused by para-influenza virus types 1 and 3 with epidemics occurring every other year. Cases may occur in the UK all year round, but hospital admission rates peak in late autumn (September to December). […] In a large population-based study, using data from April 1999 to March 2015, there were 27,355 visits for croup, admission occurred in 8.0% of the cases and 5.4% had a repeat visit within 7 days following discharge.

• #12 Croup: What It Is and How to Treat It

  https://www.uspharmacist.com/article/croup-what-it-is-and-how-to-treat-it-41766

  Croup results from a narrowing of the subglottic airway secondary to inflammation associated with certain viral respiratory tract infections and is represented by the sudden onset of a barking cough. […] Croup is diagnosed primarily by its rapid onset and its characteristic barking cough. […] The most common causes of croup today are the parainfluenza viruses; therefore, clinicians should expect a rise in cases during peak months of parainfluenza activity. […] In North America, this peak occurs in late autumn. […] Owing to the increased prevalence of parainfluenza type 1 in odd-numbered years, the incidence of croup is 50% greater during those years than in even-numbered years. […] The role of the pharmacist in the treatment of croup is multifactorial. First, it is essential to recognize croup and to refer the patient for medical treatment. Additionally, an understanding of the importance of corticosteroid treatment in improving croup and an awareness of the futility of cough suppressants and humidity therapy in treating this condition can potentially lead to a speedier recovery for the patient.

• #13 Croup (Laryngotracheobronchitis) – Core EM

  https://coreem.net/core/croup/

  Croup may be caused by a number of viruses. […] Age 6 months to 36 months most common. […] Peak mid fall to early winter. […] Peak time to visit ED 10pm-4am.

• #14 Acute Stridor – RCEMLearning

  https://www.rcemlearning.co.uk/reference/croup/

  Approximately 80% of children presenting with an acute onset of stridor and a cough have croup. […] Croup occurs in 2% of children aged between 6 and 36 months, with a peak incidence at 12 to 24 months. There is a male to female ratio of 3:2. It is more common in the spring and autumn months but can occur at any time of year. […] In 80% of cases the cause of croup is viral and the majority are parainfluenza viruses. Other viruses that cause croup are adenovirus, respiratory syncytial virus, measles, coxsackie, rhinovirus, echovirus, reovirus and influenza A and B.

• #15 Croup in the COVID-19 era

  https://www.contemporarypediatrics.com/view/croup-in-the-covid-19-era

  The pandemic has increased awareness for many infectious diseases, including croup. […] Croup is a respiratory condition based on clinical findings, such as hoarseness, a barking cough, or stridor. The condition is most common in the fall and winter, and viruses are to blame for 80% of cases. […] Most cases (85%) are mild, but about 1% end up severe. In severe cases, croup can lead to stridor and hypoxia. Up to 5% of all children with severe croup may end up hospitalized, but only between 1% and 3% ever require intubation. […] The sudden onset and loud nature of a croup cough can be concerning, especially now, when concern for COVID-19 variants are at an all-time high. However, there’s no definitive test to diagnose croup. […] There are many concerns about respiratory symptoms as the COVID-19 pandemic continues to evolve.

• #16 Croup | Diagnosis & Disease Information – Pulmonology Advisor

  https://www.pulmonologyadvisor.com/ddi/croup/

  Croup typically develops in young children, primarily during the fall and winter months. This infection affects 3% of children age 6 months to 3 years. Most children who get croup are immunocompetent, and most cases (approximately 85%) are classified as mild. Less than 5% of children with croup require hospitalization, and severe croup accounts for less than 1% of cases. Boys are more likely to develop croup than girls at a ratio of 3:2. Most patients with croup are young children. Although less common, children younger than 6 months or older than 6 years may also develop croup. […] Viral infections can be detected in approximately 80% of patients with croup. The most common inciting infection is with the parainfluenza virus (types 1, 2, and 3), which accounts for three-quarters of cases. Parainfluenza type 1 is the most common type.

• #17 Croup in Children – Janet Pate, MD, FAAP

  https://www.nurturepediatric.com/croup-in-children/

  Croup is most common in babies around 6 months of age (when they start to put their hands in their mouths) to 3 years of age. […] Viral croup is commonly caused by the Parainfluenza virus. […] Parainfluenza virus is transmitted by droplets. […] Covering your cough and hand washing are key to prevention of spread for parainfluenza virus. […] Currently in our Houston area, we are seeing an uptick in Parainfluenza Virus 4. […] Parainfluenza 1 is the most common viral form of croup. […] Unfortunately, there is no vaccine for parainfluenza virus and you can catch this illness many times over your lifetime. […] Croup-type symptoms can also be due to viruses such as influenza, RSV, rhinovirus and occasionally to bacterial causes like mycoplasma. […] Warning signs to seek immediate care by contacting your doctor: – Harsh breathing for any reason in a young child less than 4 years old.

• #18 Etiology and Epidemiology of Croup before and throughout the COVID-19 Pandemic, 2018–2022, South Korea

  https://www.mdpi.com/2227-9067/9/10/1542

  A total number of 879 croup cases were recognized during the study period. […] The most common pathogen was SARS-CoV-2 (26.9%), followed by HRV (23.8%), PIV1 (14.6%), PIV3 (13.1%), and CoV NL63 (13.1%), among seventeen respiratory viral pathogens tested by polymerase chain reaction. […] The viral identification rate was significantly higher in the Omicron period, with most of the pathogens identified as SARS-CoV-2. […] In the Omicron period, with the exponential increase in the number of COVID-19 cases in the community, croup associated with SARS-CoV-2 significantly increased, with a high detection rate of 97.2% (35 of 36) among croup cases with pathogen identified. […] The etiologic and epidemiologic data before and throughout the COVID-19 pandemic indicate that the association between croup and infection with the SARS-CoV-2 Omicron variant is highly plausible.

• #19 Etiology and Epidemiology of Croup before and throughout the COVID-19 Pandemic, 2018–2022, South Korea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9599993/

  Omicron, a recent variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently globally dominating. […] A total number of 879 croup cases were recognized during the study period. […] The viral identification rate was significantly higher in the Omicron period, with most of the pathogens identified as SARS-CoV-2. […] In the Omicron period, with the exponential increase in the number of COVID-19 cases in the community, croup associated with SARS-CoV-2 significantly increased, with a high detection rate of 97.2% (35 of 36) among croup cases with pathogen identified. […] The etiologic and epidemiologic data before and throughout the COVID-19 pandemic indicate that the association between croup and infection with the SARS-CoV-2 Omicron variant is highly plausible.

• #20 Etiology and Epidemiology of Croup before and throughout the COVID-19 Pandemic, 2018–2022, South Korea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9599993/

  The cases in this study were compared to the national surveillance data. In general, each croup epidemic (five or more cases of croup per week in clusters) was associated with a high detection rate of PIV or CoV. […] In the Omicron period, with the exponential increase in the number of COVID-19 cases in the community, croup caused by SARS-CoV-2 infection significantly increased (7.11 cases/week), with a high detection rate of 97.2% (35 of 36) among croup cases with pathogen identified. […] By investigating the etiology and epidemiology of croup in both the periods before and throughout the COVID-19 pandemic, the association of croup with SARS-CoV-2 Omicron infection is suggested. […] The observations revealed that despite extensive SARS-CoV-2 surveillance in South Korea, during the pre-Omicron period, no single croup case due to infection with SARS-CoV-2 was reported. However, after the rapid spread of Omicron, without the spread of PIV or other CoVs, croup cases due to infection with SARS-CoV-2 showed a noticeable increase. […] These observations possibly verify the association between infection with the Omicron variant and croup in children, which is consistent with the results of prior publications.

• #21 :: JKMS :: Journal of Korean Medical Science

  https://www.jkms.org/DOIx.php?id=10.3346/jkms.2022.37.e192

  Croup is a common upper airway infection characterized by a barking cough, stridor, and hoarseness. It is usually caused by viral infection. […] To the best of our knowledge, this is the first report of life-threatening croup produced by the omicron BA.2 variant and confirmed by RT-PCR. […] Our patients developed acute respiratory failure that was unresponsive to dexamethasone and multiple NRE treatments. […] Croup, also known as acute laryngotracheobronchitis, is characterized by the sudden onset of a barking cough that is usually accompanied by inspiratory stridor, hoarseness, and respiratory distress as a result of upper airway obstruction. […] The initial outbreak of COVID-19, which is caused by the SARS-CoV-2 virus, first occurred in December 2019. […] To the best of our knowledge, there have been no case reports of life-threatening croup induced by the omicron variant and confirmed by RT-PCR during the omicron variant surge. […] Our limited experience with COVID-19 croup requiring endotracheal intubation and CPR suggests that the SARS-CoV-2 variant may cause severe croup that may not be improved by conventional treatment, especially for the omicron BA.2 variant.

• #22 Pediatric Croup: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/pediatric-croup/?srsltid=AfmBOork7FwnG3BOkx3JOPc6ma-T0IALv5DYj9d-JiURTgvN5OPc2mhD

  Croup is an infection that causes upper airway inflammation and obstruction. Laryngotracheitis, or viral croup, is the most common form of croup and the most frequent cause of acute respiratory distress in children. Croup is less common in females than it is in males and most commonly occurs between the ages of 3 months to 3 years. It is uncommon to see croup in children over the age of 6. Only around 5% of children with croup have symptoms severe enough that require hospitalization. Out of those children hospitalized, approximately 1 to 3% are intubated, which has a mortality rate of 0.5%. […] Risk factors for croup include: Contact with an infected individual within past 7 days, Anatomically defective larynx, Allergies, History of croup, Recurrent upper respiratory infections.

• #23 Croup

  https://mobile.fpnotebook.com/Lung/Airway/Crp1.htm

  Incidence […] Overall Incidence: 3-6 cases per 100 children 6 years […] Accounts for 15% of pediatric respiratory visits to the emergency department (up to 400,000/year) […] Hospitalizations: 1-8% of US cases (20,000 per year) […] Intubation: 1-5% of cases hospitalized […] […] […] Boys affected more than girls by ratio of 1.5 to 1 […] Outbreaks and epidemics occur in autumn to early winter […] Can occur year round sporadically […] […] […] Affects ages under 6 years (rarely up to 8 to 12 years) […] Most common cause of Stridor in children 6 months to 3 years of age […] Typical age 6 months to 36 months of age (peaks between 12 and 24 months) […] Rare before 3 months of age […] […] […] Croup accounts for 99% of abrupt onset of Stridor […] […] […] Mild Cases: 85% […] Hospitalized: 5% […] Severe Cases: 1% […] Intubated: 0.05% of croup cases […] Mortality 0.5% (even for intubated patients) […] […] […] Croup can cause airway compromise that rivals Epiglottitis cases of the past

• #24 Epiglottitis and Croup | Ento Key

  https://entokey.com/epiglottitis-and-croup/

  Croup is the most common cause of stridor in children and accounts for up to 15% of emergency department and primary care visits for respiratory infections in the United States. […] The annual incidence ranges from 1.5% to 6% in children younger than 6 years. […] The incidence of croup is highest in the fall and early winter months. […] The mortality from croup has greatly decreased over the past 50 years secondary to advances in pediatric intensive care and airway management. Nevertheless, there are still isolated reports of mortality from croup, emphasizing the need for vigilant observation and early airway intervention in severe cases.

• #25 Croup in Children – Janet Pate, MD, FAAP

  https://www.nurturepediatric.com/croup-in-children/

  Spasmodic or Recurrent Croup can be due to other causes like allergies, asthma, GERD and anatomic problems. […] Sudden onset of cough and harsh breathing during daytime hours in a child less than 4 requires prompt attention to rule out foreign body aspiration. […] Sudden onset of harsh breathing along with a pale or dusky appearance or loss of consciousness requires 911 emergency services.

• #26 Phthalate levels in indoor dust and associations to croup in the SELMA study | Journal of Exposure Science & Environmental Epidemiology

  https://www.nature.com/articles/s41370-020-00264-7

  Phthalates are ubiquitous indoor pollutants which have been associated with child airway disease although results are inconclusive. This study examined associations between phthalate levels in residential indoor dust and croup during infancy. […] The incidence of parental reported croup at 12 months was 6.4% for girls and 13.4% for boys. […] We found significant associations between di-ethyl phthalate (DEP) and di-ethyl-hexyl phthalate (DEHP) in residential dust and parental reported croup (adjusted odds ratio (aOR)=1.71; 95% CI: 1.08-2.73 and 2.07; 1.00-4.30, respectively). […] Our results suggest that exposure to phthalates in dust is a risk factor for airway inflammatory responses in infant children.

• #27 Croup: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/8277-croup

  Croup (laryngotracheobronchitis) is a respiratory infection that affects young children. Viral infections are the most common cause of the condition. Croup causes swelling of your child’s voice box (larynx) and windpipe (trachea). This swelling causes the airway below their vocal cords to narrow, which makes their breathing noisy and difficult. […] Croup affects about 3% of U.S. children every year. The condition accounts for 7% of all hospitalizations in children younger than 5 years old. It’s more common in males. Healthcare providers define about 85% of croup cases as mild. They consider less than 1% of cases severe. […] Yes, croup is highly contagious because the viruses that lead to the condition are easily spreadable. […] Croup can spread by physical contact or through the air. To help prevent its spread: Wash and dry your hands thoroughly after caring for your child. Wash toys between each use. Encourage your child to cover their mouth and nose when coughing and sneezing. Keep your child home from school or daycare when they’re ill or if outbreaks occur. Throw used tissues away.

• #28

  https://journals.lww.com/pidj/fulltext/2016/07000/population_based_surveillance_for_medically.1.aspx

  Parainfluenza viruses (PIV) have been shown to contribute substantially to pediatric hospitalizations in the United States. However, to date, there has been no systematic surveillance to estimate the burden among pediatric outpatients. […] The Influenza Incidence Surveillance Project (IISP) provides a unique opportunity to assess the age-specific burden of PIVs in outpatient practice across multiple years and a broad geographic range in the United States. Since 2010, the IISP has monitored the year-round incidence of influenza-like illness (ILI) and associated incidence of respiratory viruses, including PIVs 14, in a network of outpatient clinics across 13 US states and jurisdictions. […] PIVs represented a substantial burden of respiratory illnesses among children in IISP, accounting for 9% of all ILI-related pediatric outpatient visits overall and up to 33% of visits at season peak.

• #29

  https://journals.lww.com/pidj/fulltext/2016/07000/population_based_surveillance_for_medically.1.aspx

  PIVs contribute substantially to the burden of medically attended ILI in children, accounting for 9% of ILI-related pediatric outpatient visits and 12% among children aged 5 years. […] It is well-established that PIVs contribute substantially to ILI morbidity and hospitalization among children, being second only to respiratory syncytial virus in hospitalizations because of respiratory tract infections among children aged 5 years.

• #30 Croup or bronchiolitis

  https://www.health.vic.gov.au/infectious-diseases/croup-or-bronchiolitis

  Croup or bronchiolitis are most often caused by respiratory syncytial virus, parainfluenza viruses, influenza and adenoviruses. […] In Australia, croup is more common in autumn and affects young children. Bronchiolitis is more common in winter and predominantly affects children in the first year of life. […] There are limited data on the epidemiology of croup and bronchiolitis in Australia. Croup is more common in autumn and affects young children. It peaks in the second year of life. Bronchiolitis is more common in winter and predominantly affects children in the first year of life. […] Public health action is dependent on the setting in which the case has occurred and is based on an assessment of ongoing risk. The risk for nosocomial transmission of RSV increases during community outbreaks. Nosocomial outbreaks of RSV can be controlled by adhering to contact and respiratory precautions.

• #31 EPIDEMIOLOGY, TREATMENT, AND COMPLICATIONS OF CROUP SYNDROME IN CHILDREN | Repository of UKIM

  https://repository.ukim.mk/handle/20.500.12188/24878

  Croup syndrome is an urgent pediatric condition. […] This study aimed to evaluate the frequency, treatment, and possible complications of croup syndrome in children hospitalized at our institute. […] Mean age at diagnosis of children with croup was 26,5 2.6 months (range from 45 days to 8 years). […] As far as the treatment, we noticed significant number of children with moderate to severe croup syndrome that required in-patient care. […] Our one-year research has documented considerable number of children with the necessary hospitalization, as many as 10% of hospitalized children in our Institute were due to moderate to severe croup syndrome. […] There is evident discrepancy between the use of antibiotics and its duration in our practice in comparison with other reports.

• #32 Duration, course and caregiver burden of croup in children: two observational cohorts | BMJ Open

  https://bmjopen.bmj.com/content/14/12/e080102

  Croup is a common respiratory illness of childhood, characterised by sudden onset of a barky cough, hoarse voice, and in moderate and severe cases, stridor and respiratory distress. Croup affects up to 3% of young children annually, occurring commonly between 6 months and 6 years of age, but occasionally even in adolescents. Croup affects 1.4 times more boys than girls. […] Although croup is common, there are limited published data describing symptom duration, and no data published addressing when symptoms peak, which symptoms persist longer nor whether duration differs with patient age or sex, season and initial severity of disease. […] The primary objective of this study was to describe the peak and duration of croup’s common symptoms in children presenting to an emergency department (ED). Secondary objectives were to determine whether age, sex, season of presentation or severity of croup at presentation were associated with duration of symptoms and describe associated caregiver stress, loss of sleep and time from work during the child’s croup illness.

• #33 Duration, course and caregiver burden of croup in children: two observational cohorts | BMJ Open

  https://bmjopen.bmj.com/content/14/12/e080102

  Most children experienced their worst symptoms at ED presentation at the time of enrolment into prospective cohorts. Specifically, in the paediatric (n=307) and general ED (n=1084) cohorts, 95.7% and 77.3% experienced their worst symptoms in the ED. […] We found symptoms were at peak severity at the initial ED presentation for the majority of children. Children’s longest-lived symptom was a barky cough, which resolved for about half of children in 1.52 days, and for 90% of children in 3-5 days. Neither sex nor illness severity at presentation predicted symptom duration. However, children with croup presenting from September to December took longer on average to resolve symptoms than those presenting from January to May. […] Croup places a significant burden on primary caregivers in stress, sleep loss and work for wages missed.

• #34 Adult croup caused by influenza A virus: a case report and literature review – Canales-Azcona – Journal of Emergency and Critical Care Medicine

  https://jeccm.amegroups.org/article/view/8717/html

  Croup is a common respiratory disease during childhood and very rare in adulthood. […] Although the cause of croup is usually viral, influenza A virus (IAV) is considered a rare etiologic agent. […] Croup in adults caused by influenza A represents an uncommon clinical entity. Our case reinforces the importance of understanding this disease, since it requires early diagnosis and treatment, and unlike croup in pediatric patients, in adults it is a severe disease and has an impact on the patients outcome and prognosis. […] AC is an extremely rare condition, with limited information available in the literature. […] In adult patients with croup, especially those exhibiting symptoms such as fever, barking cough, and stridor, prompt diagnosis and management are crucial, as AC can lead to severe outcomes.

• #35 Adult croup caused by influenza A virus: a case report and literature review – Canales-Azcona – Journal of Emergency and Critical Care Medicine

  https://jeccm.amegroups.org/article/view/8717/html

  This article aims to highlight the importance of IAV as a possible etiologic agent of croup in adults. […] Approximately 80% of the detectable causes of pediatric croup cases are viral. […] Nevertheless, croup can rarely be caused by bacteria such as Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and Corynebacterium diphtheriae. […] IAV is spread primarily through respiratory contact between individuals within six feet. […] The pathogenesis of croup begins with the infection of the virus to the epithelium of the nasal mucosa and pharynx, spreading to the larynx, causing inflammation, edema, congestion, and subglottic narrowing, which originates its classically described symptomatology. […] Croup diagnosis is eminently clinical. […] AC represents a more severe disease, some authors suggest that it is a criterion for admission to the ICU when available.

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