ICD-9: 464.4


Croup, a common childhood ailment, is acute and severe inflammation and obstruction of the upper respiratory tract, occurring most frequently from 3 months to 3 years of age. It is more common in male infants and children, usually occurring in winter.


The condition may be caused by parainfluenza virus, adenoviruses, respiratory syncytial viruses, and influenza and measles viruses. Croup generally follows an upper respiratory tract infection.

Signs and Symptoms

Common symptoms include hoarseness; fever; a distinctive harsh, brassy, barklike cough; respiratory distress; and persistent stridor during inspiration. Stridor is a harsh, high-pitched sound during respiration due to obstruction of the air passages. The infant or child may be anxious and frightened by the respiratory distress. The symptoms may last a few hours or persist for a day or two.

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Diagnostic Procedures

The clinical picture is very characteristic, so a diagnosis is made fairly quickly. Cultures of the causative organism are performed. Neck x-ray and laryngoscopy may also be performed.


Children are treated symptomatically at home in most cases with bed rest, liquids, and antipyretics. Cool humidification of the air is tried. Often children are more comfortable when in a sitting position; holding them or placing them in an infant seat may ease their breathing. If dehydration is suspected, hospitalization may be necessary and antibiotic therapy and oxygen therapy may be started.

Complementary Therapy

No significant complementary therapy is indicated.


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Keep a child as quiet as possible. Control fever with sponge baths and antipyretics. Waterbased fruit juices and Popsicles can help soothe the throat. Use of a cool humidifier or vaporizer can be helpful.


The prognosis for croup is good with treatment.


Prevention includes prompt treatment of any respiratory tract infections.

Respiratory alkalosis (Hypocapnia) ICD-9: 276.3 Description Respiratory alkalosis is excessive alkalinity of body fluids attributable to the excessive removal of carbon dioxide (CO2) by the lungs. When excessive amounts of CO2 are ventilated by the lungs, the PaCO2 in the blood decreases, initiating a series of chemical and metabolic changes that act to reduce the level of serum bicarbonate. Consequently, the pH of the blood increases. The condition may be acute or chronic. Etiology Respiratory alkalosis is caused by acute or chronic hyperventilation. Acute respiratory alkalosis may result from hyperventilation induced by anxiety or psychological trauma, fever, pain, salicylate poisoning, excessive exercise, or excessive use of mechanical ventilators. It is also associated with hypoxia due to pneumonia, asthma, or pulmonary edema. Chronic respiratory alkalosis from hyperventilation is typically associated with hypoxia due to chronic cardiopulmonary diseases or high altitudes. Signs and Symptoms The class...
Pneumonia ICD-9: 486 Description Pneumonia is an acute inflammation of the respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli of the lung. The inflammation may be either unilateral or bilateral and involve all or a portion of the affected lung. Pneumonia once was the leading cause of death in the United States, but modern antibiotics greatly lessened the incidence of the disease. However, pneumonia still affects close to 4 million people each year and causes death for almost 60,000 individuals yearly in the United States. People ages 65 and older and those with depressed immunity are at greater risk. Pneumonia is often further identified as follows: Lobar pneumonia—Affects one or more lobes of the lung Bronchopneumonia—Also known as lobular pneumonia; bacterial form of the disease Interstitial pneumonia—Characterized by progressive scarring of both lungs Etiology Pneumonia may be caused by microorganisms, such as bacteria, viruses, fungi, protozoa, or rickettsiae. Vira...
Pulmonary edema ICD-9: 514 Description Pulmonary edema is a diffuse extravascular accumulation of fluid in the pulmonary tissues and air spaces. Most commonly, it represents the projection of cardiac disease processes, such as atherosclerosis, hypertension, or valvular disease. The condition is usually a direct consequence of left ventricular failure. Pulmonary edema can occur as a chronic condition, or it can develop quickly. Pulmonary edema is considered a medical emergency. Etiology When the alveoli fill with fluid instead of air, preventing oxygen from being absorbed into the bloodstream, more blood is added to the pulmonary circulation than can be adequately removed. In addition to the cardiac problems already mentioned, pulmonary edema may also be the result of lung infections, living at high altitudes, smoking, certain toxin exposure, pneumonia, and acute respiratory diseases. Signs and Symptoms The onset of pulmonary edema frequently occurs at night, after the person has been l...
Silicosis ICD-9: 502 Description Silicosis, also known as grinder’s disease and potter’s rot, results from the inhalation of crystalline silica dust. Silica is a common mineral found naturally in sand and rock. Silica scars lungs and creates small, discrete nodules in the upper lobes of the lungs. As the disease advances, a dense fibrosis of the lungs develops, and emphysema with respiratory impairment may result. The disease is chronic and progressive. Etiology Silica exposure is common in mines and quarries and in a number of occupations, such as sandblasting, foundry work, ceramics, and glassmaking. The occupations most prone to silica exposure are mining, drilling, blasting, grinding, and abrasive manufacturing. Required exposure varies from 2 to 30 years; the average is 10 years. Signs and Symptoms The disease may be asymptomatic even though x-rays exhibit evidence of nodule formation. Dyspnea on exertion generally is the first symptom. A chronic dry cough that later turns p...
ASTHMA ICD-9: 493.9x* Description Asthma is a respiratory condition marked by recurrent attacks of labored breathing accompanied by wheezing. Asthma is an inflammatory disorder of the airways that causes spasms of the bronchial tubes or swelling of their mucous membranes. Extrinsic asthma occurs when the bronchospasm is the result of an allergic response to environmental irritants. Intrinsic asthma is present when the client suffers attacks without evidence of allergic response. Extrinsic asthma is most common in childhood; intrinsic asthma more often begins in adulthood. Asthma affects 22 million Americans, of whom 6 million are children under age 12. Etiology The etiology of asthma is uncertain. There is often a family history of allergy and an individual history of hypersensitivity. Persons with asthma have very sensitive airways that react to “triggers” that cause asthma symptoms to start or worsen. Common triggers include upper respiratory infections; allergens, such as pollens...