fever There is a form of croup, epiglottitis, that is a lifethreatening illness-a true emergency in which minutes count. It is a bacterial infection of the epiglottis (the lidlike structure that covers the entrance to the larynx) and surrounding tissues. It is most common in children between the ages of three and nine years. The fever may rise to 105CF. The difficulty in breathing quickly becomes severe. The child drools, has trouble swallowing, and prefers to sit with the head forward, mouth open, and tongue partially out. The condition rapidly progresses to choking and convulsions-it must be treated immediately SIGNS AND SYMPTOMS The key symptoms of croup are a barking cough, hoarseness, difficulty in breathing, and a crowing sound heard when inhaling. There may be no fever or only a lowgrade fever (101°F). It is important to be always watchful for the signs of epiglottitis: a high fever, difficulty in breathing and swallowing, sore throat, drooling, and preference for the characteristic position of sitting with the head forward, mouth open, and tongue partially out. Choking on a foreign object may resemble croup, since both share the same symptom of frantic efforts to breathe. However, it is easy to tell choking from croup by one important distinction-a choking child cannot speak or cry out, but a child with croup can do both. HOME CARE If a child has a serious breathing difficulty, do not try to care for him at home. Notify your doctor, and head for the nearest hospital emergency room. Mild, repeated attacks of croup can often be cared for at home (it there is no serious difficulty in breathing). However, it is best to call your doctor the first time you suspect that your child has croup. The basic home care for mild attacks is adding moisture to the air to relieve the cough and help the child breathe more easily. A humidifier or vaporizer will be helpful. (Be sure to keep it meticulously clean, however. Otherwise, it can actually become a source of infection if microorganisms are allowed to grow in it.) Steam also may be generated quickly by running a hot shower in a closed bathroom. Sit in the room with your child for a short while. If the symptoms are not relieved, call your doctor. PRECAUTIONS • If your child has a high fever, has difficulty in breathing and swallowing. is drooling, or sits with the head forward, mouth open, and tongue hanging out, get medical help immediately. • Never give any type of cough medicine to a child with croup or any difficulty in breathing. • Do not give ipecac as a home treatment for croup. Ipecac may make breathing even more difficult. MEDICAL TREATMENT Mild cases of croup can usually be treated at home. In severe cases, the child will be hospitalized, and a croup tent, which provides high humidity, will be used. The doctor may also order an xray examination, cultures, and blood tests. If the condition becomes severe, intubation (insertion of a tube into the airway) may be necessary. pox