What symptom indicates croup is severe enough for a doctor evaluation?

High-pitched stridor and retractions are critical indicators that croup is severe and warrants an evaluation by a healthcare professional. Stridor signifies significant upper airway obstruction, often caused by edema or inflammation in the larynx, which can be a concern in severe cases of croup. When stridor occurs at rest, it indicates that the airway is compromised and requires immediate attention to assess the severity of the condition and potential interventions to prevent respiratory distress.

Retractions, which involve the skin pulling in around the ribs and neck during inhalation, also reflect increased effort to breathe and suggest that the child is experiencing some form of respiratory distress. This combination of symptoms points to a higher level of urgency in managing the patient's condition, emphasizing the need for medical evaluation.

While persistent cough, fever over 100°F, and wheezing breath sounds can occur in cases of croup, they do not necessarily signify the same level of severity as high-pitched stridor and retractions. Cough may be present in less severe cases, a mild fever is common in many viral infections, and wheezing, while it can indicate respiratory issues, is not as direct a sign of severe croup as stridor and retractions are.