Croup Questions & Answers

1. Benson BE, Baredes S, Schwartz RA. Stridor. Medscape Reference by WebMD. January 26, 2010. [Full Text].

2. American Academy of Pediatrics. Parainfluenza Viral Infections. Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2003. 479-81.

3. Sung JY, Lee HJ, Eun BW, et al. Role of human coronavirus NL63 in hospitalized children with croup. Pediatr Infect Dis J. 2010 Sep. 29(9):822-6. [QxMD MEDLINE Link].

4. Williams JV, Harris PA, Tollefson SJ, et al. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Engl J Med. 2004 Jan 29. 350(5):443-50. [QxMD MEDLINE Link]. [Full Text].

5. Worrall G. Croup. Can Fam Physician. 2008 Apr. 54(4):573-4. [QxMD MEDLINE Link].

6. Bjornson C, Russell KF, Vandermeer B, et al. Nebulized epinephrine for croup in children. Cochrane Database Syst Rev. 2011 Feb 16. CD006619. [QxMD MEDLINE Link].

7. Segal AO, Crighton EJ, Moineddin R, Mamdani M, Upshur RE. Croup hospitalizations in Ontario: a 14-year time-series analysis. Pediatrics. 2005 Jul. 116(1):51-5. [QxMD MEDLINE Link].

8. Bernstein T, Brilli R, Jacobs B. Is bacterial tracheitis changing? A 14-month experience in a pediatric intensive care unit. Clin Infect Dis. 1998 Sep. 27(3):458-62. [QxMD MEDLINE Link].

9. Donnelly BW, McMillan JA, Weiner LB. Bacterial tracheitis: report of eight new cases and review. Rev Infect Dis. 1990 Sep-Oct. 12(5):729-35. [QxMD MEDLINE Link].

10. Edwards KM, Dundon MC, Altemeier WA. Bacterial tracheitis as a complication of viral croup. Pediatr Infect Dis. 1983 Sep-Oct. 2(5):390-1. [QxMD MEDLINE Link].

11. Jones R, Santos JI, Overall JC Jr. Bacterial tracheitis. JAMA. 1979 Aug 24-31. 242(8):721-6. [QxMD MEDLINE Link].

12. Sobol SE, Zapata S. Epiglottitis and croup. Otolaryngol Clin North Am. 2008 Jun. 41(3):551-66, ix. [QxMD MEDLINE Link].

13. Hoa M, Kingsley EL, Coticchia JM. Correlating the clinical course of recurrent croup with endoscopic findings: a retrospective observational study. Ann Otol Rhinol Laryngol. 2008 Jun. 117(6):464-9. [QxMD MEDLINE Link].

14. Johnson D. Croup. Clin Evid (Online). 2009 Mar 10. 2009:[QxMD MEDLINE Link]. [Full Text].

15. [Guideline] Alberta Medical Association. Guideline for the diagnosis and management of croup. Alberta Clinical Practice Guidelines 2005 Update. [Full Text].

16. Guidelines for the diagnosis and management of croup. 2008 update. Alberta Medical Association. 2011.

17. Chun R, Preciado DA, Zalzal GH, Shah RK. Utility of bronchoscopy for recurrent croup. Ann Otol Rhinol Laryngol. 2009 Jul. 118(7):495-9. [QxMD MEDLINE Link].

18. Delany DR, Johnston DR. Role of direct laryngoscopy and bronchoscopy in recurrent croup. Otolaryngol Head Neck Surg. 2015 Jan. 152 (1):159-64. [QxMD MEDLINE Link].

19. Wald EL. Croup: common syndromes and therapy. Pediatr Ann. 2010 Jan. 39(1):15-21. [QxMD MEDLINE Link].

20. Swingler GH, Zwarenstein M. Chest radiograph in acute respiratory infections. Cochrane Database Syst Rev. 2008. (1):CD001268. [QxMD MEDLINE Link].

21. Huang CC, Shih SL. Images in clinical medicine. Steeple sign of croup. N Engl J Med. 2012 Jul 5. 367(1):66. [QxMD MEDLINE Link].

22. Kirks DR. The respiratory system. Practical Pediatric Imaging: Diagnostic Radiology of Infants and Children. 3rd ed. Philadelphia, Pa: Lippincott-Raven; 1998. 651-53.

23. Bjornson C, Russell KF, Vandermeer B, Durec T, Klassen TP, Johnson DW. Nebulized epinephrine for croup in children. Cochrane Database Syst Rev. 2011 Feb 16. CD006619. [QxMD MEDLINE Link].

24. Scolnik D, Coates AL, Stephens D, Da Silva Z, Lavine E, Schuh S. Controlled delivery of high vs low humidity vs mist therapy for croup in emergency departments: a randomized controlled trial. JAMA. 2006 Mar 15. 295(11):1274-80. [QxMD MEDLINE Link].

25. Colletti JE. Myth: Cool mist is an effective therapy in the management of croup. CJEM. 2004 Sep. 6(5):357-8. [QxMD MEDLINE Link].

26. Humidified air inhalation for treating croup [database online]. Cochrane Database of Systematic Reviews; 2006.

27. Bjornson CL, Klassen TP, Williamson J, et al. A randomized trial of a single dose of oral dexamethasone for mild croup. N Engl J Med. 2004 Sep 23. 351(13):1306-13. [QxMD MEDLINE Link].

28. Cetinkaya F, Tufekci BS, Kutluk G. A comparison of nebulized budesonide, and intramuscular, and oral dexamethasone for treatment of croup. Int J Pediatr Otorhinolaryngol. 2004 Apr. 68(4):453-6. [QxMD MEDLINE Link].

29. Chub-Uppakarn S, Sangsupawanich P. A randomized comparison of dexamethasone 0.15 mg/kg versus 0.6 mg/kg for the treatment of moderate to severe croup. Int J Pediatr Otorhinolaryngol. 2007 Mar. 71(3):473-7. [QxMD MEDLINE Link].

30. Fifoot AA, Ting JY. Comparison between single-dose oral prednisolone and oral dexamethasone in the treatment of croup: a randomized, double-blinded clinical trial. Emerg Med Australas. 2007 Feb. 19(1):51-8. [QxMD MEDLINE Link].

31. Russell K, Wiebe N, Saenz A, et al. Glucocorticoids for croup. Cochrane Database Syst Rev. 2004. CD001955. [QxMD MEDLINE Link].

32. Zoorob R, Sidani M, Murray J. Croup: an overview. Am Fam Physician. 2011 May 1. 83(9):1067-73. [QxMD MEDLINE Link].

33. Gates A, Gates M, Vandermeer B, Johnson C, Hartling L, Johnson DW, et al. Glucocorticoids for croup in children. Cochrane Database Syst Rev. 2018 Aug 22. 8:CD001955. [QxMD MEDLINE Link].

34. Kairys SW, Olmstead EM, O'Connor GT. Steroid treatment of laryngotracheitis: a meta-analysis of the evidence from randomized trials. Pediatrics. 1989 May. 83(5):683-93. [QxMD MEDLINE Link].

35. Amir L, Hubermann H, Halevi A, Mor M, Mimouni M, Waisman Y. Oral betamethasone versus intramuscular dexamethasone for the treatment of mild to moderate viral croup: a prospective, randomized trial. Pediatr Emerg Care. 2006 Aug. 22(8):541-4. [QxMD MEDLINE Link].

36. Geelhoed GC. Budesonide offers no advantage when added to oral dexamethasone in the treatment of croup. Pediatr Emerg Care. 2005 Jun. 21(6):359-62. [QxMD MEDLINE Link].

37. Sparrow A, Geelhoed G. Prednisolone versus dexamethasone in croup: a randomised equivalence trial. Arch Dis Child. 2006 Jul. 91(7):580-3. [QxMD MEDLINE Link]. [Full Text].

38. Bagwell T, Hollingsworth A, Thompson T, Abramo T, Huckabee M, Chang D, et al. Management of Croup in the Emergency Department: The Role of Multidose Nebulized Epinephrine. Pediatr Emerg Care. 2017 Sep 25. [QxMD MEDLINE Link].

39. McGee DL, Wald DA, Hinchliffe S. Helium-oxygen therapy in the emergency department. J Emerg Med. 1997 May-Jun. 15(3):291-6. [QxMD MEDLINE Link].

40. Vorwerk C, Coats TJ. Use of helium-oxygen mixtures in the treatment of croup: a systematic review. Emerg Med J. 2008 Sep. 25(9):547-50. [QxMD MEDLINE Link].

41. Beckmann KR, Brueggemann WM Jr. Heliox treatment of severe croup. Am J Emerg Med. 2000 Oct. 18(6):735-6. [QxMD MEDLINE Link].

42. Terregino CA, Nairn SJ, Chansky ME, Kass JE. The effect of heliox on croup: a pilot study. Acad Emerg Med. 1998 Nov. 5(11):1130-3. [QxMD MEDLINE Link].

43. Weber JE, Chudnofsky CR, Younger JG, et al. A randomized comparison of helium-oxygen mixture (Heliox) and racemic epinephrine for the treatment of moderate to severe croup. Pediatrics. 2001 Jun. 107(6):E96. [QxMD MEDLINE Link].

44. Vorwerk C, Coats T. Heliox for croup in children. Cochrane Database Syst Rev. 2010 Feb 17. CD006822. [QxMD MEDLINE Link].

45. Moraa I, Sturman N, McGuire T, van Driel ML. Heliox for croup in children. Cochrane Database Syst Rev. 2013 Dec 7. 12:CD006822. [QxMD MEDLINE Link].

46. Dobrovoljac M, Geelhoed GC. 27 years of croup: an update highlighting the effectiveness of 0.15 mg/kg of dexamethasone. Emerg Med Australas. 2009 Aug. 21(4):309-14. [QxMD MEDLINE Link].

47. Moore M, Little P. Humidified air inhalation for treating croup: a systematic review and meta-analysis. Fam Pract. 2007 Sep. 24(4):295-301. [QxMD MEDLINE Link].

48. Cruz CI, Patel D. Impacted Button-Battery Masquerading as Croup. J Emerg Med. 2013 Jan 30. [QxMD MEDLINE Link].

49. Elbuluk O, Shiba T, Shapiro NL. Laryngomalacia presenting as recurrent croup in an infant. Case Rep Otolaryngol. 2013. 2013:649203. [QxMD MEDLINE Link]. [Full Text].

50. Ibrahimov M, Yollu U, Akil F, Aydin F, Yener M. Laryngeal foreign body mimicking croup. J Craniofac Surg. 2013 Jan. 24(1):e7-8. [QxMD MEDLINE Link].

Germaine L Defendi, MD, MS, FAAP Associate Clinical Professor, Department of Pediatrics, Olive View-UCLA Medical Center

Germaine L Defendi, MD, MS, FAAP is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Antonio Muñiz, MD Professor of Emergency Medicine and Pediatrics, University of Texas Medical School at Houston; Medical Director of the Pediatric Emergency Department, Children's Memorial Hermann Hospital

Antonio Muñiz, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, American College of Emergency Physicians, American Heart Association, American Medical Association, Society for Academic Emergency Medicine, Southern Medical Association

Disclosure: Nothing to disclose.

Rona E Molodow, MD, JD Clinical Professor, Department of Pediatrics, Olive View-UCLA Medical Center

Rona E Molodow, MD, JD is a member of the following medical societies: American Academy of Pediatrics, American Professional Society on the Abuse of Children

Disclosure: Nothing to disclose.

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Joseph Domachowske, MD Professor of Pediatrics, Microbiology and Immunology, Department of Pediatrics, Division of Infectious Diseases, State University of New York Upstate Medical University

Joseph Domachowske, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

• Print this section
• Print the entire contents of
• Print the entire contents of article