Croup in Children: Typical Age Range, Duration, and Recovery

Croup (laryngotracheobronchitis) is a viral upper airway illness causing barking cough, stridor, and hoarseness.

Epidemiology

• Peak age: 6 months – 3 years (max incidence 18–24 months).
• Season: Fall/winter (parainfluenza, RSV, influenza, adenovirus).
• Rare after age 6 (airway larger, less susceptible to subglottic edema).

Clinical Course

• Prodrome: URI symptoms 12–72 hr.
• Onset: Nighttime barking cough, inspiratory stridor, hoarseness.
• Peak severity: Nights 2–3.
• Resolution: Typically 3–7 days; cough may linger 1–2 weeks.

Management

• Mild: Cool mist, humidity, fluids, antipyretics, single-dose dexamethasone (0.15–0.6 mg/kg).
• Moderate/severe: Nebulized racemic epinephrine + dexamethasone; observe 2–4 hr post-epinephrine.
• Admission: Persistent stridor at rest, hypoxia, retractions, fatigue, dehydration.

Most children recover fully without sequelae. Recurrent croup warrants airway evaluation.