Croup is a narrowing of the air passage through the larynx, the voice box in the neck where the vocal cords are located. If the narrowing is severe, the air cannot reach the lungs, and the child begins to choke. The narrowing is caused by spasm and swelling of the larynx. These may be the result of certain bacterial infections or very severe allergy, but they are most often caused by a virus, sometimes by bacteria. Fortunately, the disease is rarely fatal. But it can be terribly frightening to both the child and the parent. It usually comes in spasms. The attack is generally precipitated at night. The mild fever and the apparent healthy look of the child between the spasms—and the fact that the child has been immunized against diphtheria—usually make it cer¬tain that the illness is croup, not the onset of diph¬theria of the larynx. However, always notify the doctor when the child develops a hoarse, croupy voice or cough, or seems to be having spasms of difficult breathing.
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