Krup
Etiologia i przyczyny
Krup (laryngotracheobronchitis) to najczęstsza przyczyna niedrożności górnych dróg oddechowych u dzieci w wieku 6 miesięcy do 3 lat, ze szczytem zachorowań około 2. roku życia. Etiologia jest głównie wirusowa, z dominującą rolą wirusów paragrypy typu 1, 2 i 3 (75-80% przypadków, z czego HPIV-1 odpowiada za niemal 66%). Inne patogeny to wirusy grypy A i B, RSV, SARS-CoV-2 oraz adenowirusy, rinowirusy i inne. Patogeneza obejmuje zapalenie i obrzęk błony śluzowej krtani, tchawicy i oskrzeli, prowadzące do zwężenia podgłośniowego i objawów takich jak szczekający kaszel, stridor i chrypka. Bakteryjny krup, rzadziej występujący, może być wywołany przez Staphylococcus aureus, Streptococcus pyogenes, Mycoplasma pneumoniae i inne bakterie, często jako wtórne zakażenie po infekcji wirusowej. Występuje także krup spazmatyczny, związany z refluksem żołądkowo-przełykowym lub reakcjami alergicznymi, różniący się brakiem objawów infekcji.
- Definicja krupu (laryngotracheobronchitis)
- Etiologia wirusowa krupu
- Główne patogeny wirusowe
- Inne wirusy powodujące krup
- Patofizjologia krupu wirusowego
- Epidemiologia krupu wirusowego
- Etiologia bakteryjna krupu
- Inne przyczyny krupu
- Czynniki predysponujące i genetyczne
- Transmisja i zakaźność
- Nawracający krup
- Zapobieganie krupowi
- Podsumowanie etiologii krupu
Definicja krupu (laryngotracheobronchitis)
Krup (laryngotracheobronchitis) to częsta choroba układu oddechowego występująca głównie u dzieci, charakteryzująca się zapaleniem i obrzękiem górnych dróg oddechowych, szczególnie krtani (larynx), tchawicy (trachea) oraz oskrzeli (bronchi). Choroba powoduje zwężenie dróg oddechowych poniżej strun głosowych, co prowadzi do charakterystycznego, szczekającego kaszlu, świszczącego oddechu (stridor) oraz chrypki. Krup jest najczęstszą przyczyną niedrożności górnych dróg oddechowych u dzieci w wieku od 6 miesięcy do 3 lat, z największą częstością występowania około 2. roku życia.123
Etiologia wirusowa krupu
Główne patogeny wirusowe
Krup jest najczęściej wywoływany przez infekcje wirusowe. Wirusy wykrywane są w nawet 80% przypadków krupu o identyfikowalnych patogenach. Głównymi czynnikami etiologicznymi są:123
- Wirusy paragrypy (typy 1, 2 i 3) – odpowiedzialne za około 75-80% wszystkich przypadków krupu, przy czym typy 1 i 2 odpowiadają za niemal 66% przypadków. Wirus paragrypy typu 1 (HPIV-1) jest najczęstszą przyczyną krupu.123
- Wirus grypy A i B – krup spowodowany wirusem grypy A jest zwykle związany z ciężką postacią choroby i znacznym upośledzeniem oddychania.12
- Wirus syncytialny układu oddechowego (RSV) – powszechny patogen wywołujący infekcje górnych dróg oddechowych.12
- SARS-CoV-2 (wirus wywołujący COVID-19).12
Inne wirusy powodujące krup
Oprócz głównych patogenów, krup może być również wywołany przez:12
- Adenowirusy
- Rinowirusy (wirusy przeziębienia)
- Enterowirusy
- Metapneumowirusy
- Koronawirusy (inne niż SARS-CoV-2)
- Wirus odry – u dzieci, które nie zostały zaszczepione przeciwko odrze
- Ludzkiego bokawirusy
- Echowirusy
- Reowirusy
Należy podkreślić, że te same wirusy, które powodują przeziębienie czy grypę, mogą również wywoływać krup, ale nie każda infekcja tymi wirusami prowadzi do rozwoju krupu.12
Patofizjologia krupu wirusowego
Wirusowa inwazja błony śluzowej krtani prowadzi do stanu zapalnego, przekrwienia i obrzęku. Powoduje to zwężenie obszaru podgłośniowego, co utrudnia przepływ powietrza i prowadzi do charakterystycznych objawów krupu. W wyniku infekcji wirusowej dochodzi do nacieków z komórek zapalnych (histiocytów, limfocytów, komórek plazmatycznych i neutrofilów) w błonie śluzowej górnych dróg oddechowych.12
Epidemiologia krupu wirusowego
Krup występuje najczęściej jesienią i wczesną zimą, chociaż może pojawić się w każdej porze roku. Interesującym zjawiskiem epidemiologicznym jest to, że od 1973 roku krup wywołany przez ludzki wirus paragrypy typu 1 (HPIV-1) wykazuje tendencję do występowania w latach nieparzystych. Niektóre badania wskazują również na skupiska przypadków krupu odpowiadające wybuchom epidemii grypy A i B.12
Krup dotyka częściej chłopców niż dziewczynki i występuje najczęściej u dzieci w wieku od 3 miesięcy do 5 lat, ze szczytem zachorowań około 2. roku życia. Dzieci te są szczególnie podatne ze względu na mniejszą średnicę dróg oddechowych.12
Etiologia bakteryjna krupu
Bakteryjne zapalenie krtani i tchawicy (bakteryjny krup) występuje znacznie rzadziej niż postać wirusowa. Zapalenie bakteryjne może wystąpić jako pierwotne zakażenie lub jako wtórne zakażenie po infekcji wirusowej (bakteryjne zapalenie tchawicy – bacterial tracheitis).12
Patogeny bakteryjne
Bakterie, które mogą wywoływać krup lub dołączać się do infekcji wirusowej, to:123
- Mycoplasma pneumoniae – może powodować łagodną chorobę podobną do krupu
- Staphylococcus aureus – najczęstsza przyczyna wtórnego bakteryjnego zapalenia tchawicy
- Streptococcus pyogenes
- Streptococcus pneumoniae
- Haemophilus influenzae typu b (Hib) – obecnie rzadko obserwowany dzięki szczepieniom
- Corynebacterium diphtheriae (przyczyna błonicy, dawniej znanej jako „błoniczy krup”) – praktycznie wyeliminowana dzięki szczepieniom
- Moraxella catarrhalis
Przed wprowadzeniem szczepień, błonica była częstą przyczyną objawów przypominających krup i często kończyła się śmiercią. Obecnie w krajach rozwiniętych przypadki te są niezwykle rzadkie dzięki skuteczności szczepionki przeciw błonicy.12
Rodzaje bakteryjnego krupu
Bakteryjny krup można podzielić na kilka podtypów:12
- Błonica krtaniowa (laryngeal diphtheria) – wywołana przez Corynebacterium diphtheriae
- Bakteryjne zapalenie tchawicy (bacterial tracheitis) – najczęściej spowodowane przez Staphylococcus aureus
- Laryngotracheobronchitis (LTB) – bakteryjne zapalenie krtani, tchawicy i oskrzeli
- Laryngotracheobronchopneumonitis (LTBP) – bakteryjne zapalenie krtani, tchawicy, oskrzeli z zajęciem płuc
Bakteryjne zapalenie tchawicy (bacterial tracheitis) jest poważniejszą chorobą niż wirusowy krup i wymaga innego leczenia, często z zastosowaniem antybiotyków.12
Inne przyczyny krupu
Krup spazmatyczny
Oprócz krupu infekcyjnego (wirusowego lub bakteryjnego), istnieje również krup spazmatyczny, który różni się od postaci infekcyjnej. Charakteryzuje się nagłym początkiem, często w środku nocy, bez wyraźnych oznak poprzedzającej infekcji. Przyczyny krupu spazmatycznego mogą obejmować:123
- Refluks żołądkowo-przełykowy (GERD) – cofanie się treści żołądkowej do przełyku i gardła
- Reakcje alergiczne – na alergeny takie jak pyłki, sierść zwierząt lub ukąszenia owadów
- Możliwa reakcja alergiczna na antygeny wirusowe, a nie bezpośredni wynik infekcji wirusowej
Niektórzy badacze sugerują, że krup spazmatyczny może być związany z nadreaktywnością dróg oddechowych, podobnie jak w astmie.12
Inne czynniki wywołujące objawy podobne do krupu
Objawy przypominające krup mogą być również wywołane przez:123
- Wdychanie substancji drażniących – cząsteczek takich jak proszek, mąka, dym papierosowy, opary chemiczne, smog
- Ciało obce – aspiracja małego przedmiotu, takiego jak orzeszek czy zatyczka od długopisu
- Zapalenie nagłośni (epiglottitis) – stan zapalny klapki u podstawy języka, która zapobiega przedostawaniu się pokarmu do tchawicy
- Ciężkie reakcje alergiczne (anafilaksja) – np. na niektóre pokarmy
Czynniki predysponujące i genetyczne
Istnieją różne czynniki, które mogą zwiększać podatność dziecka na rozwój krupu:123
- Anatomia dróg oddechowych – dzieci mają naturalnie węższe drogi oddechowe, co sprawia, że są bardziej podatne na obrzęk i zwężenie
- Predyspozycje genetyczne – zarówno spazmatyczny, jak i ostry krup są częstsze u dzieci z rodzinnym wywiadem krupu
- Wariant genu CD14 C-159T – badania genetyczne wykazały, że wariant C/C tego genu wiąże się z mniejszą częstością występowania krupu
- Wcześniactwo – dzieci urodzone przedwcześnie są bardziej narażone na rozwój ciężkiej postaci krupu
- Współistniejące problemy z oddychaniem – dzieci z historią problemów oddechowych lub astmą są bardziej narażone na rozwój krupu
Ryzyko nawracającego krupu spazmatycznego może być także zwiększone przez wcześniejszy atak tej choroby.1
Transmisja i zakaźność
Krup wirusowy jest wysoce zakaźny, ponieważ wirusy, które go wywołują, łatwo się rozprzestrzeniają. Sposoby przenoszenia obejmują:123
- Droga kropelkowa – wdychanie kropelek zawierających wirusy, które zostały wykaszlane lub wykichane przez osobę zakażoną
- Bezpośredni kontakt – z osobą zakażoną lub jej płynami ustrojowymi
- Kontakt pośredni – dotykanie powierzchni skażonych wirusem (np. zabawki, stoły), a następnie dotykanie oczu, nosa lub ust
Krup jest najbardziej zakaźny w pierwszych trzech dniach od pojawienia się objawów lub do czasu ustąpienia gorączki. Okres inkubacji (czas od zakażenia do wystąpienia objawów) wynosi zwykle od 2 do 6 dni.12
Nawracający krup
Niektóre dzieci doświadczają nawracających epizodów krupu (więcej niż dwa epizody rocznie). Nawracający krup nie jest diagnozą samą w sobie, ale może wskazywać na inną podstawową chorobę lub stan.12
Przyczyny nawracającego krupu
Nawracający krup może być spowodowany przez:12
- Nieprawidłowości anatomiczne gardła lub dróg oddechowych – wrodzone lub nabyte w wyniku urazu
- Czynniki alergiczne – dziecko może zostać uczulone na antygeny wirusowe
- Refluks żołądkowo-przełykowy – częsta przyczyna nawracającego krupu
- Nadreaktywność dróg oddechowych – podobnie jak w astmie
- Podatność indywidualna – niektóre dzieci są bardziej podatne na krup z powodu specyficznej budowy dróg oddechowych
Wiele stanów powodujących nawracający krup można leczyć, co eliminuje objawy przypominające krup.1
Zapobieganie krupowi
Całkowite zapobieganie krupowi jest trudne, ponieważ może być wywołany przez wiele różnych wirusów. Istnieją jednak środki, które mogą pomóc zmniejszyć ryzyko:123
- Szczepienia – szczepienia przeciwko grypie mogą zapobiec krupowi wywołanemu przez wirus grypy; szczepienia przeciwko błonicy i Hib praktycznie wyeliminowały te bakteryjne przyczyny krupu
- Higiena – regularne mycie rąk i unikanie dotykania twarzy
- Izolacja – dzieci z krupem powinny pozostać w domu, aby zapobiec rozprzestrzenianiu się wirusa
- Unikanie narażenia – ograniczenie kontaktu z osobami chorymi, szczególnie w sezonie jesienno-zimowym
- Aktualne szczepienia przeciwko COVID-19 – mogą pomóc dziecku zwalczyć niektóre wirusy, które mogą prowadzić do krupu
Warto podkreślić, że nie istnieje szczepionka przeciwko większości wirusów, które powodują krup, dlatego całkowite zapobieganie tej chorobie nie jest zwykle możliwe.1
Podsumowanie etiologii krupu
Krup jest głównie chorobą wirusową, z wirusami paragrypy (szczególnie typem 1) jako dominującym patogenem. Choroba może być również wywołana przez inne wirusy, rzadziej przez bakterie, lub może mieć charakter nieinfekcyjny, jak w przypadku krupu spazmatycznego związanego z refluksem lub alergią. Czynniki genetyczne, anatomiczne i środowiskowe mogą wpływać na podatność dziecka na rozwój krupu oraz jego ciężkość. Mimo że całkowite zapobieganie krupowi jest trudne, szczepienia przeciwko niektórym patogenom oraz przestrzeganie zasad higieny mogą pomóc zmniejszyć ryzyko zachorowania.123
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Materiały źródłowe
- #1 Croup: Diagnosis and Management | AAFPhttps://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. […] Viruses are detected in up to 80% of patients who have croup with identifiable pathogens. Parainfluenza virus (types 1 to 3) accounts for 75% of all cases, and human parainfluenza virus 1 is the most common type. […] Bacterial croup is less common and may be caused by Mycoplasma pneumoniae and Corynebacterium diphtheriae. The type of infectious agent does not affect outcomes or initial management.
- #1 Croup: Practice Essentials, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/962972-overview
Croup is a common, primarily pediatric viral respiratory tract illness. […] The most common viral etiologies are parainfluenza viruses. The type of parainfluenza (1, 2, and 3) virus causing croup outbreaks varies each year. […] Parainfluenza viruses (types 1, 2, 3) are responsible for about 80% of croup cases, with parainfluenza types 1 and 2, accounting for nearly 66% of cases. […] Other infectious causes for croup-like illnesses include the following: Adenovirus, Respiratory syncytial virus (RSV), Enterovirus, Human bocavirus, Coronavirus, Rhinovirus, Echovirus, Reovirus, Metapneumovirus, Influenza A and B. […] Infection with influenza A is associated with severe respiratory disease, as it has been detected in children with marked respiratory compromise. […] Prior to 1970, diphtheria, also known as membranous croup, was a common cause of croup-like symptoms. Vaccine coverage for diphtheria has eliminated this infection with no case reported in the United States for decades.
- #1 Croup in Children | Cedars-Sinaihttps://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/c/croup-in-children.html
Croup is a common infection in children. It is most often caused by a virus. […] A virus is the most common cause of croup. But the illness may also be caused by bacteria, allergies, or reflux from the stomach. […] Viruses that are known to cause croup are: Parainfluenza virus, Respiratory syncytial virus (RSV), The flu (influenza virus), Adenovirus, Enteroviruses, COVID-19. […] Croup is spread through direct contact with an infected person or their body fluids. The infection starts in the nose and throat and moves into the lungs. […] Croup is most often seen in children 3 months to 5 years old. The peak time for croup to occur is 2 years old. […] Croup is a common infection in children. It is most often caused by a virus. It causes swelling in the upper part of the airway in the neck. […] Children with croup have trouble breathing because their small airways swell.
- #1 Patient education: Croup in infants and children (Beyond the Basics) – UpToDatehttps://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics/print
Croup is a common respiratory illness in young children. It is caused by viruses that produce inflammation and swelling in the larynx (voice box) and upper trachea (windpipe) (figure 1). […] The most common cause of croup is the parainfluenza virus. Other viruses that sometimes cause croup include influenza, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the virus that causes coronavirus disease 2019 [COVID-19]), rhinovirus (the virus that causes the common cold), respiratory syncytial virus (RSV), and adenoviruses. These viruses are common causes of upper respiratory infections in children, and they do not always cause croup. […] Bacterial infection of the same area (which is called bacterial tracheitis) is a rare complication of croup that can occur during or following viral croup.
- #1 Croup (for Parents) | Nemours KidsHealthhttps://kidshealth.org/en/parents/croup.html
Kids with croup have a virus that makes their airways swell. […] The same viruses that cause the common cold also cause croup. Most often seen in the fall, croup can affect kids up to age 5. Viruses that cause croup spread easily from person to person when a sick person sneezes or cough and releases virus-filled droplets into the air. […] There are two types of croup, viral croup and spasmodic croup, both of which cause the barking cough.
- #1 Crouphttps://pmc.ncbi.nlm.nih.gov/articles/PMC4178284/
Croup is caused by a variety of viral agents and, occasionally, by Mycoplasma pneumoniae. Parainfluenza accounts for 75% of all cases, with the most common type being parainfluenza type 1. […] Viral invasion of the laryngeal mucosa leads to inflammation, hyperaemia, and oedema. This leads to narrowing of the subglottic region. […] Infections occur predominantly in late autumn, but can occur during any season.
- #1 What Is Croup? What Causes It?https://www.webmd.com/children/understanding-croup-basic-information
Croup is most common in the fall and early winter. It affects children assigned male at birth more often than children assigned female at birth. Babies and children between 3 months and 5 years of age are most likely to get croup. […] Normally, a virus causes the condition, but there are two other types of croup: spasmodic and bacterial. […] Viral croup is caused by any virus that infects your child’s voice box (larynx) and windpipe (trachea). Parainfluenza is the most common cause of viral croup. […] Spasmodic croup is less common. It comes on suddenly, often in the middle of the night. Doctors believe it may be caused by an allergy or reflux from the stomach. […] Other things can cause a cough that sounds like croup. Your child may have breathed in something with fine particles, like powder or flour. If they have an allergy, certain foods can also make their throat swell. […] Croup is very contagious, especially in the first 3 days after symptoms start or until your child’s fever is gone. Since a virus is usually the cause, it can spread through respiratory droplets that stay in the air after someone coughs or sneezes.
- #1 Croup > Fact Sheets > Yale Medicinehttps://www.yalemedicine.org/conditions/croup
Croup is usually caused by a viral infection. Less commonly, however, it can be caused by a bacterial infection. […] Viruses that can cause croup include: Parainfluenza virus (the most common cause), Flu (influenza virus), RSV (respiratory syncytial virus), Coronaviruses, including SARS-CoV-2, the virus that causes COVID-19, Rhinovirus, Enterovirus, Adenovirus, Human bocavirus, Human metapneumonovirus, Measles. […] Except for Mycoplasma pneumoniae, which can cause a minor illness similar to croup, bacterial infections are rarely the cause of croup. Other bacterial infections, including by Haemophilus influenzae type b (known as Hib) and Cornebacterium diptheriae (the cause of diphtheria), can cause croup, but they are exceedingly rare in the United States due to vaccines.
- #1 Croup: Symptoms, causes, and treatmenthttps://www.medicalnewstoday.com/articles/155932
Croup is an inflammation of the larynx and trachea, mostly seen in young children. A range of infectious conditions can lead to croup. […] Viral croup is the most common type. Acute croup is most often caused by a virus, as is recurrent, or spasmodic, croup. […] Some researchers argue that spasmodic croup may be linked to allergens such as pollen or a bee sting, or that it may be an allergic reaction to viral antigens, rather than a direct result of a viral infection. […] Bacterial croup is caused by a bacterial infection. This type is much rarer than viral croup and can be divided into bacterial tracheitis, laryngotracheobronchitis (LTB), laryngotracheobronchopneumonitis (LTBP), and laryngeal diphtheria. […] Types 1, 2, and 3 of the human parainfluenza virus account for 80 percent of all cases of croup. Human parainfluenza virus 1 (HPIV-1) is the most common cause of croup, with types 1 and 2 causing 66 percent of infections.
- #1 Croup Information | Mount Sinai – New Yorkhttps://www.mountsinai.org/health-library/diseases-conditions/croup
Croup is an infection of the upper airways that causes breathing difficulty and a barking cough. Croup is most often caused by viruses such as parainfluenza RSV, measles, adenovirus, and influenza. More severe cases of croup may be caused by bacteria. This condition is called bacterial tracheitis. […] Croup-like symptoms may also be caused by: Allergies, Breathing in something that irritates your airway, Acid reflux.
- #1 Croup: Symptoms, causes, and treatmenthttps://www.medicalnewstoday.com/articles/155932
Croup also has genetic indications. Both spasmodic croup and acute croup are more common in children with a family history of croup. The risk of spasmodic croup may also be increased by a previous attack. […] Most instances of bacterial croup, more commonly called bacterial tracheitis, are due to secondary bacterial infection from Staphylococcus aureus (S. aureus). Other bacteria that cause croup include S. pyogenes, S. pneumonia, Haemophilus influenza, and Moraxella catarrhalis.
- #1 Croup: Causes, Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/8277-croup
Croup causes swelling of your childs voice box (larynx) and windpipe (trachea). […] The most common cause of croup is a viral infection. Croup viruses include parainfluenza, influenza, respiratory syncytial virus (RSV), measles and adenovirus. Viral croup causes your childs upper airways to swell, making it difficult for them to breathe. However, these viruses are common and most children with viral infections dont develop croup. Rarely, bacteria can complicate the viral infection and make it more difficult to breathe. […] Yes, croup is highly contagious because the viruses that lead to the condition are easily spreadable. […] The viruses that cause croup spread easily through the air. When someone with a viral or bacterial infection that can cause croup sneezes or coughs, they send respiratory droplets containing croup-causing germs into the air. When your child breathes in these droplets, they can catch an illness thatll cause croup. Your child can also get croup by touching objects contaminated by germs that can cause croup.
- #1 Recurrent croup | Children’s Hospital of Philadelphiahttps://www.chop.edu/conditions-diseases/recurrent-croup
Many babies and toddlers will have a bout of croup, also known as laryngotracheitis, when an infection causes a narrowing in their throat that leads to a high-pitched noise heard when a child breathes in (called stridor) and a barking cough. […] If a child has repeated bouts of croup, more than two episodes a year, they are said to have recurrent croup. […] Recurrent and atypical croup are not diagnoses in and of themselves. They are a signal that there may be another underlying disease or condition. […] Sometimes recurrent croup signals an abnormality in the throat or airway, either that the child was born with (congenital) or due to an injury. […] Many of the conditions that cause recurrent croup can be repaired, and the child will no longer experience croup-like symptoms.
- #1 Croup | Better Health Channelhttps://www.betterhealth.vic.gov.au/health/conditionsandtreatments/croup
Croup is a viral infection of the throat and windpipe that causes noisy breathing, a hoarse voice and a harsh, barking cough. […] The viruses that cause croup are very similar to those of the common cold. They start to be infectious with the first signs, such as a runny nose and cough, and remain infectious for up to 5 days. Only about one in 10 children who get these viruses will develop croup. […] It is not usually possible to prevent croup. Many viruses can cause it and there is no immunisation available against most of them. However, immunisation against influenza is recommended as this may actually prevent croup caused by the influenza virus (influenza-induced croup). […] Antibiotics will not be of use as the viruses that cause croup will not respond to this treatment.
- #2 Croup: Practice Essentials, Etiology, Epidemiologyhttps://emedicine.medscape.com/article/962972-overview
Croup is a common, primarily pediatric viral respiratory tract illness. […] The most common viral etiologies are parainfluenza viruses. The type of parainfluenza (1, 2, and 3) virus causing croup outbreaks varies each year. […] Parainfluenza viruses (types 1, 2, 3) are responsible for about 80% of croup cases, with parainfluenza types 1 and 2, accounting for nearly 66% of cases. […] Other infectious causes for croup-like illnesses include the following: Adenovirus, Respiratory syncytial virus (RSV), Enterovirus, Human bocavirus, Coronavirus, Rhinovirus, Echovirus, Reovirus, Metapneumovirus, Influenza A and B. […] Infection with influenza A is associated with severe respiratory disease, as it has been detected in children with marked respiratory compromise. […] Prior to 1970, diphtheria, also known as membranous croup, was a common cause of croup-like symptoms. Vaccine coverage for diphtheria has eliminated this infection with no case reported in the United States for decades.
- #2 Croup: Diagnosis and Management | AAFPhttps://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. […] Viruses are detected in up to 80% of patients who have croup with identifiable pathogens. Parainfluenza virus (types 1 to 3) accounts for 75% of all cases, and human parainfluenza virus 1 is the most common type. […] Bacterial croup is less common and may be caused by Mycoplasma pneumoniae and Corynebacterium diphtheriae. The type of infectious agent does not affect outcomes or initial management.
- #2 Croup: Symptoms, causes, and treatmenthttps://www.medicalnewstoday.com/articles/155932
Croup is an inflammation of the larynx and trachea, mostly seen in young children. A range of infectious conditions can lead to croup. […] Viral croup is the most common type. Acute croup is most often caused by a virus, as is recurrent, or spasmodic, croup. […] Some researchers argue that spasmodic croup may be linked to allergens such as pollen or a bee sting, or that it may be an allergic reaction to viral antigens, rather than a direct result of a viral infection. […] Bacterial croup is caused by a bacterial infection. This type is much rarer than viral croup and can be divided into bacterial tracheitis, laryngotracheobronchitis (LTB), laryngotracheobronchopneumonitis (LTBP), and laryngeal diphtheria. […] Types 1, 2, and 3 of the human parainfluenza virus account for 80 percent of all cases of croup. Human parainfluenza virus 1 (HPIV-1) is the most common cause of croup, with types 1 and 2 causing 66 percent of infections.
- #2 Croup and Its Treatmenthttps://www.uspharmacist.com/article/croup-and-its-treatment
Croup may be due to such bacteria as Mycoplasma pneumoniae, Corynebacterium diphtheriae, or Streptococcus pneumoniae. However, viral invaders are most often responsible for pediatric croup, also known as laryngotracheobronchitis. Parainfluenza causes more than 66% of cases, and the particular variant caused by human parainfluenza virus 1 has the peculiar phenomenon of occurring since 1973 in odd-numbered years. Clinicians also observe a clustering of croup cases corresponding to outbreaks of influenza A and B. Croup resulting from influenza A is less common but more severe than croup arising from parainfluenza or respiratory syncytial virus. Other viruses that may cause croup include metapneumovirus, adenovirus, rhinovirus, enterovirus, measles virus, and herpes simplex virus. Patients usually contract these viruses via the standard mechanisms by which aerosolized viral illnesses are contracted (e.g., direct inhalation, contamination of the hands followed by touching the mucosa of the eyes, nose, or mouth). The incubation period is two to six days. Following inoculation, the progression of the viral invaders is to the nasal mucosa and trachea. […] Croup is a community-acquired infection that results in inflammation of the larynx, bronchi, and trachea. […] Croup occurs in as many as 6% of children ages 6 months to 6 years.
- #2 Croup: Causes, Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/8277-croup
Croup causes swelling of your childs voice box (larynx) and windpipe (trachea). […] The most common cause of croup is a viral infection. Croup viruses include parainfluenza, influenza, respiratory syncytial virus (RSV), measles and adenovirus. Viral croup causes your childs upper airways to swell, making it difficult for them to breathe. However, these viruses are common and most children with viral infections dont develop croup. Rarely, bacteria can complicate the viral infection and make it more difficult to breathe. […] Yes, croup is highly contagious because the viruses that lead to the condition are easily spreadable. […] The viruses that cause croup spread easily through the air. When someone with a viral or bacterial infection that can cause croup sneezes or coughs, they send respiratory droplets containing croup-causing germs into the air. When your child breathes in these droplets, they can catch an illness thatll cause croup. Your child can also get croup by touching objects contaminated by germs that can cause croup.
- #2 Croup > Fact Sheets > Yale Medicinehttps://www.yalemedicine.org/conditions/croup
Croup is usually caused by a viral infection. Less commonly, however, it can be caused by a bacterial infection. […] Viruses that can cause croup include: Parainfluenza virus (the most common cause), Flu (influenza virus), RSV (respiratory syncytial virus), Coronaviruses, including SARS-CoV-2, the virus that causes COVID-19, Rhinovirus, Enterovirus, Adenovirus, Human bocavirus, Human metapneumonovirus, Measles. […] Except for Mycoplasma pneumoniae, which can cause a minor illness similar to croup, bacterial infections are rarely the cause of croup. Other bacterial infections, including by Haemophilus influenzae type b (known as Hib) and Cornebacterium diptheriae (the cause of diphtheria), can cause croup, but they are exceedingly rare in the United States due to vaccines.
- #2 Patient education: Croup in infants and children (Beyond the Basics) – UpToDatehttps://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics/print
Croup is a common respiratory illness in young children. It is caused by viruses that produce inflammation and swelling in the larynx (voice box) and upper trachea (windpipe) (figure 1). […] The most common cause of croup is the parainfluenza virus. Other viruses that sometimes cause croup include influenza, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the virus that causes coronavirus disease 2019 [COVID-19]), rhinovirus (the virus that causes the common cold), respiratory syncytial virus (RSV), and adenoviruses. These viruses are common causes of upper respiratory infections in children, and they do not always cause croup. […] Bacterial infection of the same area (which is called bacterial tracheitis) is a rare complication of croup that can occur during or following viral croup.
- #2 Croup – Wikipediahttps://en.wikipedia.org/wiki/Croup
Croup is usually deemed to be due to a viral infection.[2][4] […] Croup can be caused by a number of viruses including parainfluenza and influenza virus.[2] Rarely is it due to a bacterial infection.[5] […] Croup is typically diagnosed based on signs and symptoms after potentially more severe causes, such as epiglottitis or an airway foreign body, have been ruled out.[4] […] Croup is usually treated with a single dose of steroids by mouth.[2][7] […] Before vaccination, croup was frequently caused by diphtheria and was often fatal.[5][10] This cause is now very rare in the Western world due to the success of the diphtheria vaccine.[11] […] Croup caused by a bacterial infection is rare.[13] Bacterial croup may be divided into laryngeal diphtheria, bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis.[5] […] The viral infection that causes croup leads to swelling of the larynx, trachea, and large bronchi[4] due to infiltration of white blood cells (especially histiocytes, lymphocytes, plasma cells, and neutrophils).[5]
- #2 What is Croup and What Causes It? – Stanford Medicine Childrenâs Health Bloghttps://healthier.stanfordchildrens.org/en/what-is-croup-and-what-causes-it/
Croup is a common respiratory illness that affects babies and young children. According to Dr. Shahin, there are several viruses that can cause croup. The most common culprit is parainfluenza virus, but other viruses, such as COVID-19, RSV (also known as respiratory syncytial virus), and adenovirus, can also cause croup. […] Croup is a common childhood illness that causes swelling in the upper airway below the vocal cords, specifically the voice box and the windpipe, Dr. Shahin says. […] Young children are more likely to be affected by croup because their airways are smaller. […] Like any illness, croup can spread easily, so children should stay home if they are sick. It usually is spread by respiratory secretions or by coughing, sneezing.
- #2 Croup: Symptoms, causes, and treatmenthttps://www.medicalnewstoday.com/articles/155932
Croup also has genetic indications. Both spasmodic croup and acute croup are more common in children with a family history of croup. The risk of spasmodic croup may also be increased by a previous attack. […] Most instances of bacterial croup, more commonly called bacterial tracheitis, are due to secondary bacterial infection from Staphylococcus aureus (S. aureus). Other bacteria that cause croup include S. pyogenes, S. pneumonia, Haemophilus influenza, and Moraxella catarrhalis.
- #2 Croup Information | Mount Sinai – New Yorkhttps://www.mountsinai.org/health-library/diseases-conditions/croup
Croup is an infection of the upper airways that causes breathing difficulty and a barking cough. Croup is most often caused by viruses such as parainfluenza RSV, measles, adenovirus, and influenza. More severe cases of croup may be caused by bacteria. This condition is called bacterial tracheitis. […] Croup-like symptoms may also be caused by: Allergies, Breathing in something that irritates your airway, Acid reflux.
- #2 Croup: Symptoms & Causes | NewYork-Presbyterianhttps://www.nyp.org/pediatrics/ent-otolaryngology/croup
Croup is caused by inflammation that partially obstructs the upper airway. […] Croup most frequently develops in children aged six months to five years old, with peak time being around two years old. […] Viral croup, or laryngotracheobronchitis, is caused by a viral infection that leads to swelling of the larynx (voice box) and subglottis (upper windpipe). This is the most common type of croup. […] Spasmodic croup occurs in the absence of a viral infection and is believed to be caused by inflammation from an allergy or reflux from a child’s stomach. […] Viruses cause most cases of croup, but it can also be caused by inflammation due to other things, such as allergies or reflux from the stomach.
- #2 Croup – Knowledge @ AMBOSShttps://www.amboss.com/us/knowledge/croup/
Viral croup (i.e., acute laryngotracheobronchitis) is an inflammation of the upper airway that occurs in young children. It is most often caused by the parainfluenza virus. […] Most common pathogen: parainfluenza viruses (75% of cases) […] Other pathogens: respiratory syncytial virus (RSV), adenovirus, influenza virus, SARS-CoV-2 (COVID-19) […] Etiology: may be triggered by allergies, airway hyperreactivity, or GERD.
- #2 Croup | NHS informhttps://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/croup/
Croup is commonly caused by a virus. Several viruses can cause croup but in most cases it is the parainfluenza virus. […] The virus can be passed on by close contact with infected people, as well as contaminated objects and surfaces. Its often spread by breathing in droplets from infected coughs or sneezes. […] Other viruses can also cause croup. These include: influenza A and B (flu viruses), the measles virus, in children who have not been immunised against measles, the rhinovirus (common cold virus), enteroviruses, the respiratory syncytial virus (RSV), which can cause severe breathing problems and pneumonia in babies. […] Less common causes of croup include: breathing in a small object such as a peanut or a pen cap (inhaled foreign body), inflammation of the epiglottis (the flap at the base of the tongue that keeps food from going into the windpipe), a severe allergic reaction (anaphylaxis), for example to certain foods, breathing in irritants such as chemicals, acid leaking back out of the stomach and into the throat (acid reflux).
- #2https://www.nni.com.sg/patient-care/conditions-treatments/acute-laryngotracheobronchitis-croup
Croup or Acute Laryngotracheobronchitis (ALTB) is a viral infection of the throat (upper airway). The virus causes swelling of the voice box (larynx) and windpipe (trachea). The swelling narrows the airway and makes breathing hard. […] Viruses are the causes of most types of croup. Occasionally, bacteria or an allergic reaction may also result in similar symptoms as croup. The most common viruses are parainfluenza virus (accounting for most croup cases), adenovirus, respiratory syncytial virus, influenza and measles. […] Children who were born prematurely or who have a history of breathing problems or asthma are more likely to develop severe croup and may require hospitalisation.
- #2 Croup – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/croup/symptoms-causes/syc-20350348
Croup is usually caused by a viral infection, most often a parainfluenza virus. […] Your child may get a virus by breathing infected respiratory droplets coughed or sneezed into the air. Virus particles in these droplets may also survive on toys and other surfaces. If your child touches a surface with a virus on it, and then touches the eyes, nose or mouth, an infection may follow.
- #2 What is Croup? Symptoms, Treatment, and When to Worry | Children’s Hospital of Philadelphiahttps://www.chop.edu/news/health-tip/what-is-croup-symptoms-treatment-and-when-to-worry
Croup is a common childhood illness that causes swelling in the upper airway. This can cause a change in voice and characteristic croupy cough that sounds like a seal or bark. There are a number of viruses that have been found to cause croup, the most common being parainfluenza virus. […] If a child has repeated bouts of croup, especially more than two illnesses a year, they are said to have recurrent croup and should be seen by a pediatric otolaryngologist, a doctor that specializes in conditions of the ears, nose and throat (ENT), to determine the underlying cause of the condition.
- #2 Croup: An Overview | AAFPhttps://www.aafp.org/pubs/afp/issues/2011/0501/p1067.html
Croup is usually caused by viruses, which are detected in up to 80 percent of patients. Parainfluenza virus (types 1 to 3) is the most common etiology (50 to 75 percent of patients with croup). Of the three types, parainfluenza type 1 is the most common. […] Other viruses that cause croup include enterovirus, human bocavirus, influenza A and B viruses, respiratory syncytial virus, rhinovirus, and adenovirus. Bacterial causes are also rare and include diphtheria and Mycoplasma pneumoniae. […] Allergic factors may play a role in recurrent croup, with the child becoming sensitized to viral antigens. Another cause of recurrent croup is gastroesophageal reflux.
- #2 Croup Information & Treatmenthttps://www.columbiadoctors.org/health-library/condition/croup/
Croup usually occurs a few days after the start of a cold and is usually caused by the same viruses that cause the common cold. […] Croup is contagious. The germs that cause it can be passed from one person to another through coughing and sneezing and through close contact. […] Staying up to date on COVID-19 vaccines and getting a flu vaccine each year may help your child fight off some of the viruses that can lead to croup.
- #3 Croup: Symptoms & Causes | NewYork-Presbyterianhttps://www.nyp.org/pediatrics/ent-otolaryngology/croup
Croup is caused by inflammation that partially obstructs the upper airway. […] Croup most frequently develops in children aged six months to five years old, with peak time being around two years old. […] Viral croup, or laryngotracheobronchitis, is caused by a viral infection that leads to swelling of the larynx (voice box) and subglottis (upper windpipe). This is the most common type of croup. […] Spasmodic croup occurs in the absence of a viral infection and is believed to be caused by inflammation from an allergy or reflux from a child’s stomach. […] Viruses cause most cases of croup, but it can also be caused by inflammation due to other things, such as allergies or reflux from the stomach.
- #3 Croup: An Overview | AAFPhttps://www.aafp.org/pubs/afp/issues/2011/0501/p1067.html
Croup is usually caused by viruses, which are detected in up to 80 percent of patients. Parainfluenza virus (types 1 to 3) is the most common etiology (50 to 75 percent of patients with croup). Of the three types, parainfluenza type 1 is the most common. […] Other viruses that cause croup include enterovirus, human bocavirus, influenza A and B viruses, respiratory syncytial virus, rhinovirus, and adenovirus. Bacterial causes are also rare and include diphtheria and Mycoplasma pneumoniae. […] Allergic factors may play a role in recurrent croup, with the child becoming sensitized to viral antigens. Another cause of recurrent croup is gastroesophageal reflux.
- #3 Croup: Diagnosis and Management | AAFPhttps://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. […] Viruses are detected in up to 80% of patients who have croup with identifiable pathogens. Parainfluenza virus (types 1 to 3) accounts for 75% of all cases, and human parainfluenza virus 1 is the most common type. […] Bacterial croup is less common and may be caused by Mycoplasma pneumoniae and Corynebacterium diphtheriae. The type of infectious agent does not affect outcomes or initial management.
- #3 Croup – Harvard Healthhttps://www.health.harvard.edu/a_to_z/croup-a-to-z
Croup is a common respiratory illness in children that causes a change in breathing with a hoarse voice and a brassy, barking cough. […] Infectious croup is caused by an infection with a virus, bacterium or other germ. In the United States, most cases of croup are caused by a virus. […] Spasmodic croup is very similar to infectious croup. It can be triggered by infection, but it isn’t caused by infection.
- #3 Croup – UF Healthhttps://ufhealth.org/conditions-and-treatments/croup
Croup is most often caused by viruses such as parainfluenza RSV, measles, adenovirus, and influenza. More severe cases of croup may be caused by bacteria. This condition is called bacterial tracheitis. […] Croup-like symptoms may also be caused by: Allergies, Breathing in something that irritates your airway, Acid reflux.
- #3 Croup in Children: Causes, Prevention and Treatments | PEMC of Floridahttps://www.toplinemd.com/pemc-florida/croup-in-children-causes-prevention-and-treatments/
Croup is typically caused by a virus, most frequently the parainfluenza virus. A child can contract the virus by inhaling respiratory droplets an infected child coughs or sneezes into the air. […] A croup that develops quickly while a child is already experiencing a mild cold, is called spasmodic croup. Possible causes of spasmodic croup include allergies and acid reflux. […] A combination of several factors compounds the risk of a child getting croup more than once, and often multiple times, throughout childhood: Children between six months and three years old are at high risk for developing croup. […] The croup virus is highly contagious among children, particularly during the first few days of infection. […] The croup virus is prevalent during the fall and winter, when children are often in close quarters together, like child care and playgroups. […] Children have smaller airways, making them more susceptible to upper airway infections.
- #3 What is Croup? Signs, Causes, Treatment and When to Worryhttps://www.bannerhealth.com/services/pediatrics/pediatrician/common-illnesses/croup
Croup is one of the most common respiratory infections in young children, often leading to a distinctive barking cough and difficulty breathing. […] Croup is a contagious viral infection that causes swelling in the upper airway, including the voice box (larynx) and windpipe (trachea). This infection can make the airway swell and narrow, leading to a unique barking cough, hoarseness and breathing problems. […] The most common cause of croup is viruses. Croup viruses include parainfluenza, influenza (the flu), respiratory syncytial virus (RSV), measles, adenovirus and SARS-CoV-2 (COVID-19). […] These viruses spread easily through the air when someone who is infected coughs or sneezes. Your child can also get croup by touching infected surfaces or objects (i.e., tabletops and toys).
- #3 Croup | HealthLink BChttps://www.healthlinkbc.ca/healthwise/croup
Croup usually occurs a few days after the start of a cold and is usually caused by the same viruses that cause the common cold. […] Croup is contagious. The germs that cause it can be passed from one person to another through coughing and sneezing and through close contact. […] Staying up to date on COVID-19 vaccines and getting an influenza (flu) vaccine each year may help your child fight off some of the viruses that can lead to croup.
- #3 What Is Croup? What Causes It? – Consensus: AI Search Engine for Researchhttps://consensus.app/home/blog/what-is-croup-what-causes-it/
Croup is typically caused by viral infections, with the parainfluenza virus being the most common culprit. Other viruses that can lead to croup include respiratory syncytial virus (RSV), adenovirus, and influenza. These viral infections lead to inflammation and swelling of the larynx, trachea, and bronchi, which results in the characteristic symptoms of croup. […] In summary, croup is a viral-induced condition causing upper airway obstruction in children, with treatment options including steroids and potentially beneficial environmental interventions like cold air exposure.