Croup (Acute laryngotracheobronchitis) is the most
common cause of upper airway obstruction of under 5
children. The word “croup” is derived from the Anglo-
Saxon word kropan which means “to cry aloud”.1 It is
caused by various viral agents and is characterized by
varying degrees of inspiratory stridor, barking cough,
and hoarseness as a result of laryngeal and/or tracheal
obstruction.2. Although most children are deemed to
have a mild and short-lived illness, many a times the
presentations are frightening and worsen during the early
hours of morning. Historically, before the advent of
corticosteroids and racemic epinephrine for treatment
of severe croup, intubation, tracheotomy, and death were
the typical outcomes.2, 3