Croup is a viral infection that primarily affects younger children, causing a barking cough and inspiratory stridor. The steeple sign, seen on an x-ray, indicates a blockage in the windpipe and can lead to proper treatment, including antibiotics or corticosteroid injections. However, it could also be a sign of a more serious condition requiring immediate medical attention.
The cough of a child suffering from croup sounds like a small dog barking exhaustively. Primarily affecting younger children and mainly caused by various viral infections, this ailment also known as croup is often identified by an x-ray examination revealing what is known as the bell ring in the throat. This narrow, pyramidal shape indicates a blockage in the windpipe near the vocal cords, but only when the x-ray is taken from the front to back, anteroposterior view.
Children are more prone to contracting this tracheal disorder, which manifests itself not only in the characteristic cough but also in a symptom known as inspiratory stridor, a shortness of breath. Because coughing and wheezing can be caused by other ailments, viral infections, and even throat blockages, radiology is used to confirm a doctor’s diagnosis of viral croup. The steeple sign and other radiological findings can help ensure an accurate diagnosis and proper treatment.
According to the journal Radiology, steeple sign is caused by a gradual swelling of the inner lining of the windpipe. Called the mucous membrane, this lining narrows as it moves up the glottis or vocal cords. The result is an x-ray image that reveals a sharp inverted “V” instead of the normal subglottal region, which instead resembles an inverted “U”.
When a doctor confirms croup through a steeple sign, treatment could go in a few directions. According to the National Institutes of Health (NIH), a croup blockage typically goes away within a week, if caused by a viral infection. If a bacterial infection has caused the steeple mark, antibiotics may be needed. Some doctors give corticosteroid injections or epinephrine medications to reduce croup discomfort and improve airflow, while others recommend aerosol respiratory treatment. At home, an over-the-counter anti-inflammatory pain reliever might help with other problems like fever, as could the services of a humidifier or steamer, although cold medicine isn’t recommended to treat this type of cough.
A steeple sign could be an indication of a more serious condition that requires immediate medical attention. To a lesser extent, doctors may only recommend observation and comfort-related treatment at home. However, the problem may be an airway obstruction more serious than the croup. Some conditions in very young children, according to the NIH, could start with croup and lead to a collapsed lung, dehydration, epiglottitis and other life-threatening problems. The latter conditions, of course, have more symptoms than wheezing and a barking cough.
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