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Pseudocroup - acute stenosing laryngotracheitis - is a disease of the upper respiratory tract caused by viruses. The viral disease spreads from the upper respiratory tract to the larynx and trachea. As a result, the mucous membrane below the epiglottis becomes inflamed, swells and narrows the airways. This also causes the typical symptoms of pseudocroup, such as a barking cough or abnormal breathing noises. Pseudocroup often occurs in the autumn and winter months.

The disease predominantly affects children - mainly between the ages of six months and five years. As the larynx of small children is still narrow, swelling affects their breathing more than that of older children or adults. Pseudocroup is therefore very rare in older children and adults.


Most cases of pseudocroup are preceded by a cold with a cough, runny nose and fever. Pseudocroup occurs when the infection spreads from the upper respiratory tract to the larynx and trachea. The typical symptoms of pseudocroup are a dry and barking cough, hoarseness and breathing noises when inhaling. The barking cough usually occurs at night or in the morning. The symptoms usually subside quickly on their own. However, if shortness of breath occurs, a doctor should be contacted immediately. Severe breathlessness also has the following symptoms:

  • Tightening of the skin when breathing (for example between the ribs)
  • Whistling when breathing
  • Accelerated breathing
  • Paleness and bluish discolouration of the lips
  • Quivering of the nostrils when breathing

Depending on which symptoms are present, doctors differentiate between four degrees of severity of false croup and the patient is treated accordingly depending on the degree of severity:

  • Severity 1: Breathing noises when inhaling only on exertion, barking cough, hoarseness
  • Severity 2: Breathing noises when inhaling even at rest, slight shortness of breath, slight retraction of the front of the throat
  • Severity 3: Breathing noises when breathing in and out, shortness of breath at rest, retraction of the chest, pallor, rapid pulse (>160/min)
  • Severity 4: Breathing noises when breathing in and out, severe shortness of breath, blue colouration, risk of suffocation, slow pulse, increasing drowsiness


In most cases, pseudocroup is mild and heals on its own. If the child suffers from a dry and barking cough, a few measures can prevent the illness from becoming more severe. Parents should provide cool and moist air at these times (open the window or take the child outside), calm the child down and keep them upright, reduce the fever, give fluids and - if necessary - administer anti-inflammatory ibuprofen. As a rule, a child will survive a timely and comprehensively treated pseudocroup without harm.

A progressive, severe course is rare. In these rare cases, however, pseudocroup can lead to severe respiratory distress, which must be treated in a hospital. Here it is particularly important to determine whether it is pseudocroup or the very rare but more dangerous epiglottitis. This must be treated immediately by a doctor in any case.

In contrast to pseudocroup, a child with epiglottitis appears seriously ill, and in some cases, consciousness is impaired. In addition to shortness of breath, the sick child has other symptoms that do not occur with pseudocroup: High fever, barely perceptible speech, inability to swallow and salivation, and the barking cough typical of pseudocroup is also absent. Thanks to vaccinations (combined vaccination against diphtheria, tetanus, whooping cough, polio, hepatitis B and Haemophilus influenzae type b), epiglottitis now occurs only rarely.


False croup is caused by a viral infection. In many cases, false croup is preceded by a cold. The typical symptoms of the disease - a barking cough and abnormal breathing noises - occur when the infection spreads from the upper respiratory tract to the larynx and windpipe, narrowing the airways. Pseudocroup mainly affects children aged between six months and five years. As the larynx of small children is still narrow, swelling affects breathing in small children more than in older children or adults.

False croup is most commonly caused by parainfluenza viruses, while flu, rhino, RS, adeno or measles viruses or bacterial infections are less commonly responsible. Infection occurs through droplets - i.e. coughing, sneezing or close contact with a sick person. Allergies, air pollution or polluted air in rooms (e.g. from cigarette smoke) favour the disease.


Pseudocroup is usually diagnosed based on the typical complaints and a precise description of the symptoms. Complaints such as a dry and barking cough, hoarseness and a whistling sound when inhaling indicate pseudocroup. In many cases, this information can also be recorded by a doctor without the specialist having to examine the patient in person or on-site. A doctor can therefore diagnose pseudocroup easily via telemedicine and in many cases treat it over the phone or video.

If the pseudocroup is associated with severe shortness of breath, this should always be treated in the hospital.

An in-depth examination is necessary if epiglottitis is suspected. To rule out this suspicion, a doctor will carefully examine the patient's throat.


The treatment of pseudocroup depends on the severity of the illness. In most cases, general measures are sufficient to alleviate pseudocroup: Parents should provide cool and moist air during these moments (open windows or go outside with the child), calm the child and keep them upright, reduce the fever, give fluids and - if necessary - administer anti-inflammatory ibuprofen. Severe cases of pseudocroup with acute respiratory distress must be treated in a hospital.

As part of further therapy, cortisone suppositories can reduce the swelling of the mucous membrane so that the affected person can breathe more easily again. Only in very rare cases does a child find it so difficult to breathe that the respiratory distress has to be treated with medication such as adrenaline inhalations.


Pseudocroup cannot be prevented in the true sense of the word. If a dry and barking cough occurs in a baby or toddler, a few measures can help prevent the symptoms from worsening: fresh and cool air, calming the child and keeping them upright, reducing the fever and administering fluids. It is also advisable not to smoke indoors, as this air pollution has an unfavourable effect on the illness. If a child shows symptoms of pseudocroup, it is advisable to contact a doctor. This way, the severity of the illness can be assessed and it can be ruled out that another illness is responsible for the symptoms - for example allergies or the rare epiglottitis.

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