Croup and parainfluenza virus

Parainfluenza infection can inflame the voice box and nearby upper airway. A child may develop a hoarse voice, barking cough, or a harsh sound when breathing in. Some children have fever or cold symptoms, while others do not; symptoms and breathing effort matter more than naming the virus.

Testing is not always needed to recognise croup. A clinician uses the history and examination, including how the child breathes when calm. The infection can spread through respiratory droplets and contaminated hands or surfaces.

Keep the child calm and upright, encourage regular fluids, and reduce exposure to smoke. Handwashing and avoiding close contact with vulnerable people while the child is unwell can reduce spread. Use only medicines recommended for this child and follow the instructions provided.

Arrange a child health consultation if symptoms are significant, recurrent, or unclear. If airway swelling causes breathing difficulty, a clinician may consider medicine or nebuliser treatment based on the examination.

Get emergency help when noisy breathing continues while the child is resting, the ribs or neck pull in with breaths, the child cannot speak or cry normally, lips look blue or grey, swallowing is difficult, or the child becomes floppy or hard to wake.

Seek prompt medical advice for worsening symptoms, poor drinking, markedly reduced urine, or increasing sleepiness. Do not wait for a test result if the child is working hard to breathe.

Ask whether the pattern fits croup, whether testing would change care, how long infection precautions are sensible, and which breathing signs require emergency help. Confirm how to give any prescribed medicine and when a review is needed.