What should you know about croup and high fever?

Croup is swelling around the upper airway, often after a viral illness. Its recognizable features include a barking cough, hoarse voice, and a harsh sound when breathing in. Fever can occur with viral infections, but a high temperature is not the only measure of severity: breathing effort, alertness, skin colour, and hydration are also important.

A child with croup may breathe more noisily when crying, yet persistent noisy breathing while settled is more concerning. Other illnesses can resemble croup, so a clinician may need to examine the throat, chest, and breathing pattern.

Keep the child upright, quiet, and away from smoke. Offer fluids in small amounts and check that the child is passing urine. Use only age-appropriate fever medicine according to a clinician's or package instructions, and avoid alternating medicines unless a clinician has explained how.

Arrange prompt child health assessment when fever is high, persistent, or paired with worsening symptoms. Treatment may include medicine to reduce airway swelling; nebuliser treatment is considered by clinicians in particular situations.

Call emergency services for severe breathing effort, pauses in breathing, blue or grey lips, inability to swallow saliva, marked limpness, confusion, or difficulty waking. Seek urgent medical care for noisy breathing at rest, dehydration, a rapidly worsening illness, or fever with a stiff neck, seizure, or unusual rash.

Ask what may be causing the fever, whether the airway needs treatment, how to monitor breathing during sleep, which fluids and fever medicine are suitable, and when a review is needed.