Croup

Croup, a common viral laryngotracheitis in children aged six months to three years, presents with a characteristic barking cough and inspiratory stridor. Diagnosis remains primarily clinical, often following a 12 to 48-hour viral prodrome. Dexamethasone serves as the gold-standard intervention, significantly reducing hospital readmissions and return visits by approximately 50%. For moderate to severe cases, nebulized racemic epinephrine provides rapid, transient relief of airway edema, necessitating structured reassessment. Clinicians must maintain a high index of suspicion for mimics like bacterial tracheitis, epiglottitis, or foreign body aspiration, especially when patients fail to respond to standard therapy. Minimizing patient agitation is essential, as distress significantly increases airway resistance. While most cases resolve within 48 hours, early recognition of severity and accurate differential diagnosis remain critical for preventing rare but serious outcomes.