Croup: Viral Causes and Pathophysiology
Croup (laryngotracheobronchitis) is caused by multiple viruses, not a single pathogen. Common etiologies:
- Parainfluenza viruses (types 1, 2, 3) – leading cause
- Respiratory syncytial virus (RSV)
- Adenovirus
- Influenza viruses
- Measles virus (rare in vaccinated populations)
- Human metapneumovirus, coronaviruses
Infection triggers subglottic inflammation and edema, narrowing the pediatric airway and producing the characteristic barking cough, stridor, and hoarseness. Treatment focuses on dexamethasone and nebulized epinephrine for moderate-severe cases.
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