Pseudocroup, infected croup, or subglottic laryngitis is an inflammation of the larynx that can occur more frequently in young children than in adults. The cause of this disease is a viral infection of the respiratory tract, which leads to a narrowing of the airways, so that the affected person sometimes suffers from shortness of breath and a barking cough. Treatment by a doctor is advisable.


What is pseudocroup?

Pseudocroup is an inflammation that can be localized below the glottis and in the area of ​​the larynx. Pseudocroup is a disease of the upper respiratory tract and is manifested by hoarseness and a barking cough. In extreme situations, shortness of breath can also occur. See whicheverhealth for Cat Scratch Disease Meanings.

The disease very commonly affects children and infants aged six months to six years. Adults and older children are less likely to be affected. Younger children are therefore more likely to suffer from pseudocroup, since their larynx is still relatively narrow in contrast to the older ones. The real Krupp is far more dangerous than the pseudo-Krupp.


While true croup is identical to laryngeal diphtheria, pseudocroup is caused by parainfluenza viruses or, very rarely, by measles, rhino or RS viruses. According to this, pseudocroup is a viral infection, as a result of which the laryngeal mucosa underneath the vocal cords becomes inflamed.

The resulting swelling and thick mucus constricts the airways, making it difficult for the patient to breathe. Due to the fact that the larynx is often narrowed in small children and swelling therefore has greater effects, it is mainly infants and small children who suffer from pseudocroup.

In addition, the weather also plays a certain role in the outbreak of the disease pseudocroup. Thus, most cases of pseudocroup occur in autumn or winter, and especially in cold, damp weather and when the upper layers of the air are warmer than the lower ones. If this is the case, one speaks of a so-called inversion weather situation, which favors pseudocroup.

Furthermore, the scientists suspect that there is a certain connection between the pollutant emissions from industrial plants and the occurrence of pseudocroup.

Symptoms, Ailments & Signs

A typical symptom of pseudocroup is a dry, barking cough that occurs in fits and starts in the evening or at night. The voice can become hoarse and shortness of breath occurs due to obstruction of the airways. When inhaling, whistling or squeaking noises can be heard. Since the disease usually occurs as a result of a cold, typical symptoms such as a cold or fever can also appear.

In addition, there is a general feeling of illness, the patient feels tired and weak. If the shortness of breath increases, the lips and fingertips can turn blue due to the lack of oxygen. An acceleration of the heartbeat (tachycardia) is also possible. Because these symptoms appear frightening, the patient becomes restless, which in turn can increase the presenting symptoms.

In adults, the symptoms are usually much less severe than in children. The symptoms tell you what stage the disease has reached. If only hoarseness and coughing are present, stage 1 is present. Stage 2 is characterized by soft breathing sounds when inhaling, stage 3 by shortness of breath, tachycardia, anxiety and facial pallor. Stage 4 of the disease is present when the shortness of breath increases, the pulse can only be felt very flatly, breathing sounds are present both when breathing in and when breathing out, the skin turns blue and consciousness is clouded.

course of the disease

With pseudocroup, patients are tormented by a barking cough characteristic of this disease. Hoarseness associated with a whistling sound on inspiration is also characteristic of pseudocroup. If the larynx is very constricted as a result of the swelling and inflammation, severe shortness of breath can also occur in pseudocroup, which very often manifests itself in very labored breathing and a retraction of the throttling fossa and the intercostal spaces.

If the oxygen supply is so disturbed as a result of the shortness of breath in pseudocroup, the fingernails and lips can turn blue and, in rare cases, heart palpitations can occur. A sudden appearance at night is typical for pseudocroup.


Most cases of pseudo-croup heal without complications. If the course is severe, however, it is possible for the airways to become extremely narrow. Breathing then becomes so strenuous for the person concerned that he pulls in the intercostal spaces and the throttling pit. If the obstruction of the respiratory tract finally leads to an insufficient supply of oxygen to the body and the brain, the heart starts racing, and then the lips and fingernails turn bluish.

The shortness of breath usually causes great anxiety to those affected, who are usually small children. The resulting panic further aggravates the original symptoms. Under these circumstances, the disease can become life-threatening and, in rare cases, fatal. This is especially true if the disease breaks out at night without warning. Then there is a risk that the children will not receive medical treatment in time.

In rare cases, a pseudocroup infection can also spread to the middle ear, trachea or lungs. Then there is a risk of an acute middle ear infection, tracheitis (inflammation of the windpipe) or pneumonia (inflammation of the lungs). These diseases can usually all be treated very well. However, further complications due to these secondary diseases are still possible.

When should you go to the doctor?

If the typical whistling noise occurs when inhaling, often associated with hoarseness and a sore throat, pseudocroup may be present. Before that, cold symptoms with fever and chills can occur in connection with the disease. If the symptoms do not disappear quickly, the doctor must be consulted. At the latest when the lips and facial skin turn bluish, medical advice is required. A very high fever indicates another illness that needs to be clarified by a doctor. Pseudocroup occurs mainly after a viral infection with measles or influenza viruses.

Babies and small children as well as adults with chronic respiratory diseases are particularly affected. Patients at risk should go to the doctor quickly with the symptoms mentioned. If the symptoms occur in connection with cold air, cigarette smoke or environmental toxins, pseudocroup can also be the underlying cause. It is best for those affected to contact their family doctor or an ENT doctor. Depending on the severity of the disease, other respiratory disease specialists may need to be involved in the treatment.

Treatment & Therapy

If the shortness of breath is particularly threatening in pseudo-croup , the mucous membrane can be deflated very quickly by nebulizing with adrenaline and thus alleviating the symptoms of pseudo-croup. Furthermore, cortisone preparations, for example prednisone, are very often prescribed for pseudocroup. In pseudocroup, these are administered either as a suppository into the anus or, much more rarely, via a venous access.

If the pseudo-croup patient is in an extremely poor condition, he must be transferred to a hospital, where a so-called endotracheal intubation under general anesthesia is usually carried out in the case of pseudo-croup. A hollow probe, usually made of plastic, is inserted through the vocal folds on the larynx and into the trachea either through the nose or the mouth. The airways are sealed with the help of a balloon, which means that no more secretions can penetrate. As a result, external ventilation of the pseudocroup patient is now possible.


Pseudocroup usually has mild symptoms and heals completely within three to five days. Severe forms often require inpatient treatment. In these cases, doctors administer inhaled adrenaline and high doses of glucocorticoids, and oxygen is given in the case of respiratory failure. Outpatient aftercare includes regular routine checks to assess the general condition and to initiate appropriate therapy if the symptoms increase.

Parents should always contact the doctor treating them if they have difficulty swallowing, if the fever lasts longer than three days or if signs of shortness of breath appear again. There are also self-help groups and parent initiatives on the subject of croup syndrome for the relatives. Many useful tips make it easier to deal with respiratory infections.

Here, too, the doctor can name the right contact person. Counseling centers offer the opportunity to exchange information about pseudo-croup, to receive suggestions for therapy measures and to benefit from the experiences of other parents as part of the aftercare. Since a pseudo-croup attack can recur in children, treatment recommendations from doctors and specialists are particularly important.

This concerns, for example, the correct way of dealing with the recurrence of a pseudo-croup attack. Insured persons can also obtain competent information on viral Krupp from the telephone service center of their health insurance company. Experts such as medical specialists, registered nurses and nutritional coaches on the medical hotlines provide specific information and valuable guidance on all questions relating to the clinical picture of pseudocroup 365 days a year.

You can do that yourself

A pseudo-croup attack burdens parents and child. As a parent, it is important to remain calm and keep your own nervousness away from the coughing child: hectic rush and stress can sometimes trigger a panic attack, which further worsens the shortness of breath. During an acute attack, the parents should therefore have a calming effect on the child and try to distract it as much as possible by doing something together. In the event of severe pain or clouding of consciousness, a doctor must be consulted immediately.

Cool, damp neck wraps have proven effective as home remedies to prevent further swelling of the mucous membranes around the larynx. Alternatively, ice cubes wrapped in a cloth can be used. Drinking small sips of tea or still mineral water can also have a soothing effect: however, parents must ensure that the child does not choke.

To prevent this, it is advisable to keep the air in the room as cool and moist as possible. Especially in the evenings, damp cloths can be hung up in the children’s room or humidifiers can be attached to the heating. In addition, children suffering from croup should spend as much time outdoors as possible, salty air by the sea brings long-term relief in many cases. In addition, a balanced diet rich in vitamins helps to strengthen the immune system.