Certain serious conditions can cause crouplike symptoms. These conditions include:

• Tracheomalacia. In this condition, the walls of the windpipe (trachea) collapse with inhalation because of soft or weakened cartilage. Tracheomalacia usually is present at birth (congenital), usually improves by 6 to 12 months of age, and disappears by 18 to 24 months of age. Symptoms of tracheomalacia include coarse, noisy breathing (stridor), prolonged exhaling, and a cough that may sound like croup.
• Epiglottitis. The epiglottis is the tissue that covers the opening of the windpipe (trachea). Inflammation of this tissue, or epiglottitis, usually does not produce the classic coughing symptoms of croup, but a child often experiences great difficulty swallowing. Also, children with epiglottitis usually feel and may look worse than they sound; children with croup usually sound worse than they feel.
• Bacterial tracheitis. Bacterial tracheitis is a rare, serious infection of the windpipe (trachea) that may have symptoms similar to croup. Symptoms of bacterial tracheitis include a high fever, a sore throat, a loose, harsh cough, and pain under the breastbone (sternum). A child with bacterial tracheitis appears much sicker than a child with croup and needs immediate medical attention.
• A foreign object in the airway. If your child cannot talk, cough, or breathe, he or she is choking and requires emergency medical care. Call 911 or emergency services immediately. Use the Heimlich maneuver for a child older than age 1 or an infant if you know how, or emergency services can guide you on technique until medical help arrives.