Corticosteroids and Group: Comments from a Grass Rooted Ivory Tower

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Abstract
Dorland defines croup as "a condition resulting from acute obstruction of the larynx caused by allergy, foreign body, infection or new growth, occurring chiefly in infants and children and characterized by resonant barking cough, hoarseness and persistent stridor." Life was simpler when we distinguished false (spasmodic) from true (diphtheritic) croup! Now, we recognize many etiologies, often viral in origin. In some lofty quarters, accepted opinion might hold that controlled studies have failed to show any value of steroid medication; however, my opinion is based more on 37 years of pediatric practice than on my 13 years in the "tower." A number of laryngologists and anesthesiologists recommend corticosteroids, especially dexamethasone, for treatment of laryngeal edema, even though it is less acceptable to many pediatric faculties and house staffs.

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