The word croup comes from the Early Modern English verb croup , meaning "to cry hoarsely"; the name was first applied to the disease in Scotland and popularized in the 18th century.  Diphtheritic croup has been known since the time of Homer 's Ancient Greece and it was not until 1826 that viral croup was differentiated from croup due to diphtheria by Bretonneau .   Viral croup was then called "faux-croup" by the French and often called "false croup" in English,   as "croup" or "true croup" then most often referred to the disease caused by the diphtheria bacterium .   False croup has also been known as pseudo croup or spasmodic croup.  Croup due to diphtheria has become nearly unknown in affluent countries in modern times due to the advent of effective immunization .  
The use of antibiotics and short-acting beta-2-agonist bronchodilators in children with typical croup are rarely indicated because of the low incidence of bacterial infection (<1:1000 cases of croup) as well as for physiological reasons. An otorhinolaryngology (ORL) consultation for airway evaluation is indicated when croup symptoms are persistently severe despite treatment. Outpatient referral to ORL is recommended for children with multiple croup episodes and for those who present outside the usual age group for typical croup ( Figure 1 ).
What’s the ER treatment for croup?
Dexamethasone is a steroid given by mouth that reduces inflammation. It is a one-time dose given in the ER that is effective for about four days, so no further doses are needed at home. Dexamethasone takes several hours to really kick in, so we often use another medicine in the ER called racemic epinephrine. Racemic epinephrine is an inhaled medicine given with a nebulizer machine that also reduces the swelling of the voice box. It is the most effective medicine for bringing immediate relief for stridor.