False croup with fever in children. False croup in children: symptoms and treatment

Any cold can cause unexpected complications. This is especially true for children whose bodies are at the stage of formation and growth. The incomplete anatomy of the larynx causes all sorts of problems with the respiratory tract. One of these serious pathologies is false croup. It often occurs against the background of infectious diseases of the throat and is characterized by severe swelling of the subglottic region of the larynx. A very dangerous condition if treatment is not started in time. Timely first aid and contacting a doctor guarantee recovery.

False croup, medically called stenotic or acute obstructive laryngitis, is an inflammatory disease of the airways characterized by tissue swelling and laryngeal stenosis. It is called “false” because it differs from the “true” croup. The latter occurs against the background of diphtheria infection and is manifested by the formation of serous films on the tonsils. But this is not typical for false croup; only swelling develops. The disease is distinguished from classic laryngitis by the obligatory presence of an obstructive symptom such as narrowing of the lumen of the larynx.

Croup is diagnosed mainly in children from one to four years of age, and sometimes occurs in preschoolers. Boys get sick more often than girls. This disease is very rarely recorded in adults. This age limit is due to the special structure of the larynx of babies and a poorly developed nervous system. Their respiratory passage is funnel-shaped and very small. This feature contributes to the rapid development of the inflammatory process and the formation of edema. Seasonality also affects the incidence, which peaks in the last months of autumn and early winter.

The occurrence of the disease involves two main groups of causes - bacterial and viral. In most cases, croup occurs due to a viral infection - influenza, chickenpox, herpes, measles, whooping cough. The bacterial basis of false croup is recorded much less frequently and usually occurs in a severe form. In this case, infection occurs with microorganisms such as streptococci, staphylococci, pneumococci or hemophilus influenzae.

Most often, children's false croup appears as a complication of the following diseases:

acute viral respiratory infection (ARVI),
pharyngitis
chronic tonsillitis,
scarlet fever,
flu,
measles,
adenoiditis,
chicken pox,
diathesis,
rhinitis,
rickets,
immunodeficiency,
allergies.

In addition, provoking factors can be all kinds of postpartum injuries, suffocation of the fetus during childbirth, ordinary vitamin deficiency due to artificial feeding of the baby, the period after vaccination, excess weight, as well as a weakened body after suffering from infectious diseases.

Only a pediatrician or ENT doctor can make a correct diagnosis after an in-person examination. The clinical picture of false croup is quite typical, so it is usually diagnosed based on a visual examination of the throat and listening to the lungs. Additionally, laboratory tests are prescribed: microlaryngoscopy, oral smear to determine the pathogen, blood tests. In case of a complicated course of the disease, an x-ray of the sinuses and lungs, rhino-, pharyngo- and otoscopy are done.

In addition to making the correct diagnosis, it is important to differentiate from diphtheria (true) croup, the treatment of which is significantly different. True is accompanied by a gradual narrowing of the larynx, loss of voice and a gray coating on the mucous membrane. In the false form, this sign is absent, the voice never completely disappears, and stenosis usually develops rapidly.

False croup must be distinguished from other diseases that are accompanied by laryngeal hyperemia. We are talking about allergic reactions, epiglotitis, respiratory tract oncology, asthma, peritonsillar abscess. A foreign object entering the throat can also cause stenosis.

Symptomatic picture of childhood croup

Symptoms of croup are very typical for a qualified pediatrician. But how can you recognize the onset of the disease before the doctor arrives, since it usually begins at night?

Typically, false croup develops in the first few days after the onset of influenza or ARVI and is a complicated course. The main symptoms of false croup indicate the onset of the disease: significant hoarseness of the voice, a strong barking cough, noisy heavy breathing. Due to lack of air, the lips turn blue, breathing becomes frequent and superficial, and the child is scared. In infants under 1 year of age, everything develops very rapidly and can quickly lead to asphyxia, so you need to immediately call an ambulance.

The presence of temperature is determined by the type of pathogen and the general condition of the child’s body. It can be low-grade or reach 40°. High temperature is characteristic of bacterial infection and influenza pathologies. When palpating the neck, lymphadenitis is revealed - enlargement of the lymph nodes. When inhaling, even without a phonendoscope, wheezing and wheezing can be heard.

The manifestation of a particular symptom depends on the stage of laryngeal stenosis. There are four of them:

Compensated stage

There is slight shortness of breath when moving and overexcitement. Difficulty breathing and wheezing can only be heard with a phonendoscope. The child is conscious, relatively calm, sometimes coughs, and the heartbeat is slightly rapid.

Subcompensated

Shortness of breath remains constantly, even in a relatively calm state. When inhaling, dry wheezing is clearly audible, a frequent barking cough appears, and the voice deepens. There is a slight lack of air (oxygen starvation), lips turn blue, and the skin turns pale. The heart rate increases, agitation increases, and insomnia appears.

Decompensated

Characterized by severe shortness of breath with deep, unproductive inspiration. There is a severe cough, severe bluishness of the skin, and increased sweating. When listening to the pulse, strong tachycardia is observed with periodic disturbances in the rhythm of heartbeats. Increased excitement is replaced by lethargy, severe drowsiness, and confusion. Strong wheezing can be heard in the lungs.

Hypoxia

At this stage of the disease, the child is in extremely serious condition, the symptoms of croup are pronounced. There is no noisy and hoarse breathing, no hacking cough. Shallow, irregular breathing, slow heart rate, and arterial hypotension are observed. Consciousness is very confused, gradually turning into a hypoxic coma. At this stage of the disease, seizures are possible. In the absence of emergency assistance, asphyxia quickly develops, leading to cardiac arrest and death.

False croup can move from one stage to another within a day, from severe respiratory problems to almost complete normalization of the condition. But this is no reason to calm down. At the slightest suspicion, you need to urgently call an ambulance. A mild form of obstructive processes in the larynx can be treated at home under the supervision of a pediatrician. Severe respiratory dysfunction requires immediate hospitalization and inpatient treatment. It is important to know that the disease tends to recur in conjunction with asthmatic attacks.

Helping a sick child on your own

False croup usually manifests itself late in the evening or at night. At the very first and slightest signs of shortness of breath in a child, you need to call an ambulance. Before the ambulance arrives, parents should take first aid measures. These include the following immediate actions:

the infant should be picked up and reassured, you can give him a small amount of plain water or warm milk,
open the window so that there is a lot of fresh air in the room, or take the baby in the stroller to the balcony,
dress the child in loose clothes that will not compress the chest and neck,
if you are very nervous, as a distraction, you can steam your feet in hot water or breathe in the steam from the water in the bathroom,
do not leave a sick baby alone for more than a second and constantly monitor the progression of symptoms,
if there is a strong spasm of the larynx, you need to press your finger on the root of the tongue, thus provoking the urge to vomit.

Parents should control themselves and not panic. The mother's excited state will be passed on to the child. And this, in turn, will worsen the baby’s well-being and lead to greater reflex shortness of breath. If the ambulance recommends hospital treatment, you should not refuse. The child’s life depends on the efficiency of treatment measures.

It is not recommended to give your child oil medicines, honey and mint for croup, or to use any medications without a doctor’s prescription. This is especially true for throat sprays, which themselves can cause laryngospasm. Self-medication is strictly prohibited; only preventive measures to ensure the child’s peace are allowed.

Treatment and prevention of disease

Treatment of false croup in children should begin as soon as possible to prevent the development of the disease and asphyxia. It should have several directions:

antipyretics to reduce body temperature,
antihistamines to relieve tissue swelling,
antiviral therapy to destroy a viral infection,
antibiotics in case of bacterial complications,
antitussive medications if you have a barking cough.

The main treatment for false croup is aimed at relieving an attack of stenosis of laryngeal tissue. For this purpose, antispastic and sedative drugs are used, as well as glucocorticosteroids. Antihistamines are also prescribed to relieve swelling and reduce the cough reflex - Fincarol, Diazolin, L-Cet, Claritin. For non-productive dry cough, antitussive medications are used - Codeine, Codelac, Noscapin, Coldrin, Tusuprex.

Croup, caused by bacteria, is treated with broad-spectrum antibiotics. A specific drug can only be prescribed by a doctor after a thorough examination. The standard regimen is not suitable for this disease, because it can only worsen the already serious condition of the child.

If there is a high temperature, antipyretic drugs should be given. Children's analogues of Paracetamol and Ibuprofen are recommended - Panadol and Nurofen. Aspirin should never be used to reduce the temperature in children, especially with false croup.

Sometimes the disease is accompanied by nasal congestion, which further aggravates breathing problems. In this case, you can instill your nose with children's vasoconstrictor drops. With a rapid increase in suffocation, vasoconstrictor drops can be dripped onto the tongue. They are able to slightly relieve swelling and expand the respiratory lumen.

A mild form of croup, not accompanied by severe obstructive disorders, is well treated with inhalation. This can be regular steam from boiled potatoes or a special nebulizer with an herbal solution. This procedure is not suitable for children under 3 years of age. It can be replaced with warm mustard plasters and compresses on the chest and neck area.

False croup, with correct diagnosis and timely, competent treatment, in most cases ends favorably with 100% recovery. But it is also prone to relapses. In such a case, your home medicine cabinet should always contain essential drugs to relieve an attack.

The main task of parents is to prevent the development of false croup in the child and to prevent attacks of narrowing of the larynx. To do this, you need to follow preventive measures:

prevention and timely treatment of infectious diseases of the respiratory tract,
adequate treatment of acute infectious diseases and influenza,
maintaining a comfortable microclimate in the children's room - cool air and humidity,
maintaining hygiene - washing hands, toys, food, wet cleaning,
relief of allergens that can cause stenosis,
prevention of chronic throat diseases (for example, chronic tonsillitis),
limiting contact with sick children and adults, because croup is transmitted by airborne droplets.

Some adults are faced with a situation where, against the background of a seemingly common cold, the child suddenly becomes worse and doctors diagnose false croup.

Parents who do not know what false croup means in children cannot soberly assess the situation, do not understand how this threatens the child, and do not know what to do in this case.

What is this, false croup?

Croup is a suffocation with hoarseness that develops due to inflammatory lesions of the larynx, which may be accompanied by a barking cough. Croup can be true or false.

The cause of true croup is fibrinous inflammation of the mucous membranes of the larynx with the formation of characteristic films on its walls.

This inflammation is caused by the highly contagious diphtheria bacillus, which releases a strong toxin that can disrupt the functioning of the heart and kidneys. Even in the first half of the last century, due to progressive suffocation, the mortality rate from diphtheria was 100%, so treatment of true croup is carried out only in an infectious diseases hospital, using specific and antitoxic therapy, under the constant supervision of doctors.

We have found out what true croup is, it’s time to figure out what false croup is. This is a synonym for a rather serious disease - acute stenotic laryngotracheobronchitis. It occurs due to influenza, various acute respiratory viral infections, adenoviral infections, parainfluenza, scarlet fever, measles, etc., as well as allergies.

As such, false croup in children is not one, but a whole group of diseases:

acute stenosing (subglottic) laryngitis - most often observed in children 5-6 years old, since the larynx is still small in size and with a cold, favorable conditions are created for the development of the edematous-inflammatory process in the subglottic space;
acute stenosing laryngotracheobronchitis most often manifests itself in children under 3 years of age and it is characteristic that girls get sick 2-3 times less often than boys;
acute laryngotracheitis with stenosis, characterized by simultaneous damage to the mucous membranes of the larynx and trachea, can develop at any age.

With false croup in a child, as a result of damage to the mucous membranes of the larynx and trachea, edema develops, which leads to a narrowing of the lumen of the respiratory tract.

Forms of false croup

Although the leading symptom of false croup is suffocation, the forms of this disease can be different:

Edema form - the name of this form speaks for itself. Hoarseness and difficulty breathing appear due to excessive accumulation of fluid in the interstitial space.
Catarrhal-edematous - swelling of the mucous membranes is accompanied by inflammation with severe hyperemia, without the formation of any plaque.
Edematous-infiltrative – in which the inflammatory process spreads deep into the tissues, not limited only to the mucous membranes. With this form of croup, inflammation can affect ligaments, muscles, and superficial layers of cartilage.
Fibrinous-purulent - occurs in the absence or improper treatment of the edematous-infiltrative form of croup. The mucous membranes are covered with fibrin plaque with purulent plugs.
Hemorrhagic form - characteristic of croup of viral etiology (for example, with influenza). Its features are hemorrhages into the thickness of the mucous membranes, petechial or extensive confluent hemorrhagic spots appear on the vocal and aryepiglottic folds.
Ulcerative-necrotic is an advanced form of the disease. It is characterized by necrosis of tissues of all layers, the appearance of difficult-to-heal ulcers, which can lead to the melting of cartilage.

In childhood, the most characteristic forms of false croup, due to the small size of the larynx, will still be catarrhal and edematous-infiltrative. In addition, in children, false croup can recur with every cold.

Distinguishing swelling of the larynx

Since the trigger for the development of false croup in a child is respiratory infections, the child will first have symptoms characteristic of the primary disease: general weakness, lethargy, fever, runny nose, etc. In order to prevent false croup in children in a timely manner, parents must know how this complication begins and be able to distinguish its signs.

Symptoms of false croup appear suddenly, usually at night. Often this complication develops 2-3 days after acute respiratory viral infection, but there are cases of false croup appearing in the midst of complete health.

False and true croup.

So, the characteristic symptoms are:

Stridor is difficult, bubbling and wheezing breathing. The louder the noise and whistle during inhalation and exhalation, the greater the swelling of the larynx. Speech with stridor does not disappear, but the character of the voice simply changes - it becomes squeaky. This is one of the diagnostic criteria for false croup in its differential diagnosis with suffocation, in the event of a foreign body entering the respiratory tract, when speech reproduction becomes impossible.

The appearance of stridor, and most importantly, its increase, indicates the need for urgent medical attention.

Hoarseness and hoarse voice are considered symptoms of false croup only in the presence of stridor. If there is no stridor, these are signs of laryngitis or laryngotracheitis without swelling of the mucous membranes.

Barking cough - appears before stridor, which just characterizes the beginning of swelling.

In order not to confuse false croup with an attack of bronchial asthma, you should listen to the child’s breathing. With stridor, both inhalation and exhalation will be noisy, and during an asthma attack, inhalation is not heard, but exhalation is difficult and is accompanied by loud noises.

The main thing is not to panic!

Many mothers, especially when there is more than one child in a family, are concerned about the question of whether false croup is contagious in children and how long this disease lasts.

Firstly, false croup is not contagious, since it is not a disease, but a complication of a primary respiratory infection. That's why she's contagious. But, again, one should take into account on what day from the onset of the disease the swelling appeared, and what specific disease provoked it. If the primary diagnosis is known, the contagious period is known.

If a child takes antibiotics or other specific therapy, infection from him is unlikely. Secondly, if false croup was caused by an allergic reaction, there can be no talk of infecting other children.

Symptoms of croup last for about three days. With adequate therapy, the prognosis is favorable. Very rarely, false croup drags on.

How severe is the disease?

Based on how pronounced the narrowing of the lumen (stenosis) of the larynx is, three degrees of croup are determined:

I degree stenosis - the child’s voice is hoarse; in a calm state, breathing is not disturbed, even. During an attack, when inhaling, a slight retraction of the intercostal spaces and jugular fossa may be observed.
Second degree stenosis - the child is in an excited state, noisy breathing is heard, during inhalation the wings of the nose swell and all auxiliary muscles are involved. Redness of the skin gives way to cyanosis. Pulse increased.
III degree stenosis - excitement is replaced by lethargy, stridor is pronounced with loud breathing, which is clearly heard at a distance, with anxiety the cough intensifies and becomes more frequent. Tachycardia, persistent nasolabial cyanosis appears, and the child becomes covered in cold, sticky sweat. The pupils dilate and an expression of fear appears on the face.

If the process progresses, respiratory arrest (asphyxia) may occur. Some classifications distinguish it as IV degree stenosis.

It should be remembered that in young children, degree I stenosis can very quickly develop into II and even III.

Treatment at home is possible only for minor stenosis of the first degree and in children over 3 years of age. In all other cases, immediate hospitalization with constant monitoring of the child is required.

The baby may be hospitalized in the infectious diseases or ENT department. Stage III-IV stenosis requires hospitalization in the intensive care unit.

What to do with false croup?

If parents do not know how to relieve an attack of incipient suffocation on their own, they should definitely call an ambulance, but under no circumstances should they panic. Children are great at detecting the slightest changes in their parents’ mood, and unnecessary panic can provoke an increase in symptoms.

Treatment of false croup in children should always be comprehensive and, in addition to adequate drug therapy, requires proper care for the sick child and the organization of a regimen.

Emergency care for false croup consists of quickly restoring the patency of the respiratory tract and eliminating oxygen starvation. Only the doctor should decide how to treat the baby.

Manifestations of grade I stenosis can be reduced by performing procedures with a reflex-distracting effect:

hot baths for 5-10 minutes or mustard foot baths (if the child’s temperature is above 37.5°C, baths are contraindicated);
Mustard plasters have a good distracting effect;
soften cough with alkaline inhalations, repeated every 3 hours;
Warm hydrocarbonate waters for drinking are also recommended;
among medications, pipolfen, diphenhydramine or suprastin are prescribed;
For hyperthermia, ibuprofen or paracetamol can be given.

Doses of drugs must strictly correspond to the age of the child!

First aid for false croup with degree II stenosis also involves the use of distracting procedures, inhalations and warm drinks. In addition to parenteral administration of antihistamines, dehydration therapy (glucose with calcium gluconate) is mandatory.

To improve blood supply in the pulmonary circle, aminophylline is prescribed. To relieve swelling and inflammation - prednisolone or dexamethasone. Pulmicort relieves asthma attacks well.

You need to know that berodual does not work in the case of false croup.

In case of II-III degree stenosis, baths should not be used. Repeated steam inhalations are required. Antibiotics and sedatives must be added to medications prescribed for milder degrees of stenosis.

Children with III-IV degrees of stenosis are required to be hospitalized in the intensive care unit, where mucus is removed using direct laryngoscopy, and the cavities of the larynx and trachea are completely sanitized.

If the desired effect does not occur, circulatory failure is manifested by an increase in symptoms, the child is intubated through the nasal passage or a tracheostomy is applied.

Is there any prevention?

Prevention of false croup involves hardening and general prevention of ARVI, vitamins, natural phytoncides, room ventilation and wet cleaning.

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

False croup in children: features of the disease

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

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

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

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

Types and types of false croup in children

The classification of this, which is quite dangerous in children, depends on several factors and helps specialists in choosing the right treatment. False croup is of two types - bacterial and viral. This division of pathology is directly related to the nature of the origin of the disease. Also, false-type croup is usually classified according to the presence of complications into complicated and uncomplicated.

But most often in clinical practice in children, what is considered false croup, is divided according to the degree of development of stenosis in the larynx:

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

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

Causes of false croup in childhood

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

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

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

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

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

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

False croup: symptoms and manifestations in children

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

Types of disease

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

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

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

Their characteristics can be seen in the table:

STAGES OF LARRYNAL STENOSIS	CLINICAL MANIFESTATIONS
STAGE 1	Seizures are quite rare; in the absence of seizures, the baby is active and alert. The attack itself is characterized by the appearance of slight cyanosis on the nasolabial triangle, the child’s voice becomes hoarse, and at night short periods occur, accompanied by a dry and barking cough. Also at this stage of the disease, children have moderate shortness of breath.
STAGE 2	The child becomes restless and overly excited. Very noisy and heavy breathing is accompanied by tension in the neck muscles and retraction of the intercostal spaces. Almost constant shortness of breath appears, and periods of barking cough become noticeably more frequent. Paleness of the skin of the face and circumlabial cyanosis are constantly present. Also at this stage, the heartbeat noticeably accelerates and tachycardia appears.
STAGE 3	The baby is constantly in alternating states of inhibition or excitement, his consciousness is mostly confused. Shortness of breath becomes so severe that it makes it difficult to inhale. The exhalation is very short. The breathing process itself is also accompanied by retraction of the intercostal spaces and noticeable tension in the neck muscles. The skin takes on an earthy tint and is constantly covered in cold, sticky sweat, and the legs, arms and face become bluish. The heart beats irregularly and very quickly
STAGE 4	Signs of false croup in children at this stage of development are very severe. The baby is completely unconscious. He tries to breathe, but instead gasps for air with his open mouth to no avail. The baby's skin becomes completely cyanotic, the pupils are dilated, and breathing is shallow. Convulsions, irregular pulse and slow cardiac activity indicate the onset of complete suffocation

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

Diagnosis of false croup

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

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

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

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

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

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

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

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

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

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

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

Features of drug therapy

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

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

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

If the pathology is bacterial in nature, and infectious complications develop against its background, antibacterial drugs are mandatory, and if it is viral, antibacterial drugs are prescribed. False croup is also treated with bronchodilators. It is also necessary to take into account how cough syndrome is relieved in this disease. Here, with an unproductive, dry and barking cough, preference is given to antitussive drugs, and if there is abundant sputum in the larynx, specialists prescribe intravenous administration of calcium gluconate.

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

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

Many parents are concerned about the question of whether, with such a pathological condition, it is possible to carry out therapeutic measures at home without going to the hospital for this. For the most part, the answer from otolaryngologists is negative, since an acute attack of false croup in children
stops only in stationary conditions. But if the pathological condition occurs in a child for the first time, and is not accompanied by pronounced symptoms or any complications, such a therapeutic approach is quite acceptable.

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

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

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

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

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

Consequences of the disease

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

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

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

obstructive bronchitis;
pneumonia;
purulent meningitis.

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

Prevention of false croup in children and adolescents

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

Prevention of false croup in children is as follows:

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

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

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

Informative video

False croup in children is a syndrome characterized by a triad of clinical symptoms: wheezing, barking cough, hoarseness. The syndrome is formed in diseases accompanied by an acute inflammatory process in the mucous membrane of the larynx and trachea.

With false croup, the inflammatory process is localized on the mucous membrane of the subglottic (subglottic) area of the larynx.

The development of false croup is associated with three main mechanisms:

the inflammatory process causes swelling of the space under the vocal cords, which narrows the lumen of the larynx;
reflex spasm of the laryngeal muscles causes obstruction;
the secretory activity of the glands of the mucous membrane of the larynx increases, and the already narrowed lumen of the larynx becomes clogged with a viscous inflammatory secretion.

Parents of children who are prone to recurrent attacks of false croup need to ensure that the correct microclimate is maintained in the room where the child is.

False croup most often occurs in children of early and preschool age. This is due to the anatomical and physiological characteristics of the children's larynx and trachea:

small diameter of the lumen of the trachea and bronchi, short narrow vestibule, funnel-shaped (instead of cylindrical) shape of the larynx;
relative weakness of the respiratory muscles;
disproportionately short, high-lying vocal folds;
hyperexcitability of the adductor muscles that close the glottis;
functional immaturity and susceptibility of reflexogenic zones;
abundance of lymphoid tissue with weak development of elastic fibers in the mucosa and submucosa, prone to the development of edema.

Source: miksturka.info

Synonyms: acute stenosing laryngotracheitis, viral croup, pseudocroup.

Causes of false croup in children

The most common cause of false croup in children is a viral infection. The most typical pathogens of the disease include influenza viruses, parainfluenza, herpes, measles, chickenpox, whooping cough, and adenoviruses. The predominant etiological factor is parainfluenza virus type I. The syndrome can also occur as a complication of adenoiditis, acute pharyngitis, chronic tonsillitis, measles, rhinitis, scarlet fever, influenza, chickenpox, ARVI.

False croup of bacterial etiology is less common. As a rule, bacterial microflora (Haemophilus influenzae, streptococci, staphylococci, pneumococci) joins the viral one in case of weakened immunity.

Non-infectious causes of false croup in children include laryngeal injuries, allergic edema, kidney and cardiovascular diseases. Mechanical blockage of the lumen of the larynx can occur due to aspiration of foreign bodies.

With an uncomplicated course, false croup in children, as a rule, ends in recovery.

Contributing factors are: decreased immunity, increased excitability of the nervous system, rickets, vitamin deficiency, a tendency to allergic reactions, exudative-catarrhal and lymphatic-hypoplastic diathesis, birth injuries, fetal hypoxia suffered during childbirth, paratrophy, post-vaccination period, artificial feeding, congenital stridor, hypertrophy of the lymphadenoid ring.

Forms

Depending on the cause of the disease, viral and bacterial false croup are distinguished.

Based on the presence/absence of complications, false croup in children can be complicated or uncomplicated.

Based on clinical manifestations, four degrees of stenosis are distinguished:

Compensated.
Subcompensated.
Decompensated.
Terminal (asphyxia).

Symptoms of false croup in children

Symptoms of false croup in children depend on the degree of laryngeal stenosis. The syndrome usually develops on the second or third day of an acute infectious disease with damage to the upper respiratory tract, mainly in the evening or at night. The onset is sudden and acute. The child becomes restless, noisy breathing, inspiratory type of shortness of breath, and rough, barking coughing attacks appear. The severity of the condition is determined by obstructive respiratory failure, the severity of toxicosis, and the addition of complications.

Source: fantasyclinic.ru

With laryngeal stenosis of the 1st degree, the following are observed:

no signs of impaired external respiration at rest, inspiratory shortness of breath during physical exertion and anxiety;
shortening or loss of respiratory pauses between inhalation and exhalation;
increase in depth and noise of breathing;
the presence of isolated wheezing in the lungs, appearing mainly on inspiration;
bradycardia and compensated respiratory acidosis.

Before the doctor arrives, first of all, it is necessary to provide the child with access to fresh air, calm him down, and give him a warm alkaline drink.

With stenosis of the 2nd degree, clinical symptoms increase; the phenomena of stenosis can be permanent or paroxysmal in nature. Signs of 2nd degree:

stenotic breathing at rest and during exercise, constant shortness of breath of an inspiratory nature, audible at a distance;
significantly hoarse voice;
retraction of compliant places of the chest (jugular fossa, supraclavicular and subclavian fossae, intercostal spaces, epigastrium) due to increased work of the respiratory muscles;
dry wheezing in the lungs;
pallor of the skin and visible mucous membranes, perioral cyanosis (bluish coloration of the nasolabial triangle), worsening during a coughing attack;
tachycardia, anxiety, sleep disturbances;
subcompensated respiratory or mixed acidosis.

Grade 3 stenosis is characterized by signs of respiratory decompensation and circulatory failure, a sharp increase in the work of the respiratory muscles. Symptoms of grade 3 stenosis:

superficial, quiet cough;
sharply hoarse voice;
pronounced cyanosis of the nasolabial triangle, pallor of the skin;
paradoxical breathing, inspiratory shortness of breath with extremely difficult inhalation;
an increase in breathing resistance, which leads to activation of the respiratory muscles and a sharp retraction of the yielding areas of the chest;
maximum excursions of the larynx during inhalation and exhalation;
rough wheezing of various sizes, and then a uniform weakening of breathing in the lungs during inhalation and exhalation;
hypoxemia (low oxygen content in the blood);
sticky cold sweat on the scalp and face;
muffled heart sounds, arrhythmia, tachycardia, paradoxical pulse (loss of pulse wave or slower pulse on inspiration);
anxiety, feeling of fear or lethargy, drowsiness, confusion.

You can use reflex therapy: prepare a foot bath to cause reflex vasodilation, press on the root of the child’s tongue to provoke vomiting, tickle his nose, causing a reflex sneeze.

With grade 4 stenosis, there is a sharp deterioration in breathing, and the severity of inspiratory dyspnea and obstructive syndrome increases. Terminal symptoms:

shallow, frequent, intermittent or arrhythmic breathing with periodic apnea;
the skin is pale with an earthy tint, the nail phalanges are sharply cyanotic;
atony of the diaphragm, vocal folds;
thread-like pulse, difficult to determine;
convulsive syndrome;
sharpening of facial features, dilation of pupils;
drop in blood pressure, muffled heart sounds, bradycardia, then asystole;
hypoxemia and hypercapnia, deep combined acidosis;
confusion, possible hypoxic coma.

The child's condition is extremely serious, he becomes indifferent, indifferent, and does not ask for help. False croup with grade 4 stenosis has a high risk of death due to paralysis of the respiratory center.

Diagnostics

The diagnosis of false croup in children is based on the presence of a characteristic triad of symptoms, auscultation data, and laryngoscopy.

When auscultating the lungs, wheezing and stridor breathing are heard.

In order to visually assess the condition of the mucosa, laryngoscopy is performed. During laryngoscopy, swelling of the mucous membrane of the subglottic space and prolapse of the epiglottis can be detected.

Bacteriological analysis (smears from the surface of the palatine arches and the back wall of the pharynx, nose) is carried out to exclude diphtheria, identify and identify a pathogen of a bacterial nature. The establishment of mycoplasma or chlamydial flora is carried out using ELISA and PCR methods.

To assess the degree of oxygen starvation of the body, the gas composition of the blood and the acid-base balance are examined.

Diagnosis of complications, if necessary, includes pharyngoscopy, rhinoscopy, otoscopy, radiography of the lungs and paranasal sinuses.

Children with grade 3 false croup, as well as with progression of grade 2 stenosis during therapy, are subject to hospitalization in the intensive care unit.

Differential diagnosis is carried out with true diphtheria croup, epiglottitis, acute obstructive bronchitis, foreign body in the larynx or trachea, laryngeal papillomatosis, retropharyngeal abscess, and other diseases that may be accompanied by laryngeal stenosis.

Treatment of false croup in children

Treatment of false croup in children involves early hospitalization with complete and timely etiopathogenetic therapy.

Before the doctor arrives, first of all, it is necessary to provide the child with access to fresh air, calm him down, and give him a warm alkaline drink.

You can use reflex (distractive) therapy: prepare a foot bath to cause reflex vasodilation, press on the root of the child’s tongue to provoke vomiting, tickle his nose, causing a reflex sneeze.

Further treatment is carried out in a hospital. The choice of methods is determined by a specialist and depends on the severity of the stenosis and the severity of the child’s condition.

Etiotropic therapy involves taking antiviral drugs, interferons. In case of bacterial complications and severe laryngeal stenosis, antibacterial therapy is prescribed. For subcompensated and decompensated laryngeal stenoses, parenteral administration of corticosteroids and inhalation of hydrocortisone are indicated. To influence the spasmodic component, drugs are used that reduce the contractile activity and tone of the muscles of the larynx and trachea.

Considering the possibility of an allergic component participating in the development of false croup, antihistamines are included in the complex of therapeutic measures to eliminate edema.

Non-infectious causes of false croup in children include laryngeal injuries, allergic edema, kidney and cardiovascular diseases. Mechanical blockage of the lumen of the larynx can occur due to aspiration of foreign bodies.

Mucolytic and expectorant drugs help thin and remove mucus from the respiratory tract; they are usually prescribed in the form of aerosols and inhalations, sometimes in the form of syrups, throat softening lozenges.

False croup in children. Almost everyone has heard about this disease, but rarely can anyone boast of deep knowledge on this issue. To eliminate a possible “blind spot” from your knowledge about childhood diseases, read this article.

When false croup occurs, an acute inflammatory process forms in the child’s trachea and larynx. Since there is a very large amount of loose tissue in the trachea and larynx, edema of varying intensity develops quite quickly.

Typically, false croup occurs as a consequence of the following diseases: influenza, whooping cough, scarlet fever, adenoviral infection, measles. It often happens that the disease is provoked by allergy attacks, because the larynx swells due to a reaction to certain allergens. Very often, children suffer from this disease due to the special anatomical structure of the children's respiratory tract. Its peculiarity is that the trachea and bronchi in a child are much narrower than in adults. They also differ in shape: it is not cylindrical, but funnel-shaped.

The children's larynx also contains vessels, the number of which is much greater than in an adult. All together, these factors indicate that the body of children has a greater tendency to form various swellings of the larynx, and this, in turn, leads to spasm of the larynx and suffocation. The sad fact is that the younger the child, the more difficult the attack process is.

Features of false croup

There are two types of croup that doctors distinguish: true diphtheria and false diphtheria. Both of them can lead to a characteristic cough and difficulty breathing. There are, however, differences in symptoms between the two types of cereals. The most important difference is this:

Diphtheria develops gradually; dense films slowly begin to appear in the child’s larynx. As the films increase, breathing becomes more and more difficult, lymph nodes become enlarged, and the body temperature rises quite high. In a situation where a child develops an attack of false croup, everything begins quite suddenly and proceeds quickly. Breathing problems occur due to very severe swelling of the mucous membrane of the respiratory tract.

Precautions and prevention of false croup

The best effect will come from the throat hardening method. Carrying out these procedures will not be difficult. It will be enough to simply monitor how the child gargles with water. Initially, water at room temperature is used, then the water temperature is gradually lowered over several months. Eventually the water should be almost ice cold. Excessive haste in this procedure will be absolutely unacceptable, otherwise the child will get sick.

You should also pay special attention to the child's nutrition. Often an attack of false croup occurs due to various allergic reactions, and food allergies are no exception. Doctors advise parents to remove foods that cause food allergies from their child’s diet. However, you need to include more lactic acid products, such as kefir, in your baby’s daily diet.

The demi season is the time when a child most easily catches attacks of false croup. The reasons for this sometimes lie in our “weather” illiteracy. There is nothing surprising here, because in winter, when it is frosty outside, we adhere to a simple and clear rule: the child must be dressed warmly. Off-season weather can easily deceive us: lure us with the rays of the sun and immediately blow us away with a bone-piercing wind. The result is obvious - the baby catches a cold, which, as mentioned earlier, can provoke attacks of false croup.

Signs of false croup

An attack of false croup usually frightens parents very much. But in this situation, panic is absolutely unacceptable, because providing first aid is an extremely important task. The attacks usually occur at night, during sleep. False croup shows the following symptoms.

Before the onset of an attack of false croup, the child's breathing becomes harsher. If a doctor were examining the child at this moment, he would hear faint wheezing. However, parents themselves will not be able to recognize such changes. Only a slight lethargy of the baby may be noticeable, but parents often attribute this condition to fatigue after an active day of play.

In fact, the situation is already heating up: inside the child’s body, the virus has deployed its “control”. The baby's sleep becomes restless, because due to the swelling of the throat that has begun, breathing becomes more and more difficult. When the swelling becomes most severe, a very dry, rough, “barking” cough will appear. Breathing sharply increases, the number of inhalations and exhalations per minute increases from the normal value of 30 to 50-60. By breathing rapidly, the body tries to compensate for the lack of oxygen.

An attack can also trigger an increase in body temperature, which will cause the swelling to become even greater. The cough is getting rougher. If in this situation the parents are unable to wake up and provide the child with the necessary first aid, then the risk that the baby may lose consciousness and suffocate becomes very high.

First aid for an attack of false croup

All fathers and mothers will be able to provide first aid to a child if he has an attack of false croup. If you notice the following symptoms in your baby: cough, wheezing, wheezing, immediately open all the windows in the room where the sick child is. As noted earlier, during such attacks a person lacks oxygen, which is why an influx of fresh air can alleviate the patient’s condition.

It is also worth maintaining normal air humidity in the room. This measure will be an excellent means of preventing the occurrence of attacks of false croup. Now there are a lot of different special air humidifiers on the market. With their help, you can easily maintain the required level of humidity in the room. There is also an effective “manual” method - in the patient’s room, a damp cloth is hung on the headboard of the bed, chair, or radiator. Inhalations will also be effective in alleviating the child’s condition.

In addition, the child must immediately take antihistamines; they will remove the allergic component and reduce the degree of swelling of the throat. After providing first aid, you must urgently call an ambulance. Only a doctor can determine the correct diagnosis and degree of laryngeal stenosis.

If the doctor insists on hospitalization, do not refuse. Because when false croup is confirmed in children, serious treatment may be required, even tracheal intubation, if necessary. After all, despite the fact that the doctor will relieve the attack, there remains a fairly high probability that it will recur in a couple of hours, and this time in a severe form. Even if they sincerely want to help you, ambulance specialists will not be able to post a guard near your home. Please do not risk the health and life of your child!