Your child has croup accompanied by a high fever (103 F or more).
Home remedies are not working and the croup symptoms seem to be worsening.
Your child has croup and seems to be breathing faster than normal, is having extreme difficulty breathing, cannot talk, or is turning pale or blue. These are all symptoms of severe respiratory distress. Call 911 or your emergency number for immediate emergency help.
Your child has noisy, rapid breathing; a foreign object may be stuck in his throat or lung tubes.
Your child suddenly begins drooling or can't swallow, has a high fever but no cough, and is leaning forward but can't bend his neck and can't talk. Your child may have a dangerous bacterial infection called epiglottitis, which causes a blocked airway. Do not open the mouth to look inside; doing so can completely close the throat and shut down the child's breathing. Call 911 for immediate emergency help. Your child is at particular risk for this problem if the primary immunization series (first three sets at 2, 4, and 6 months) has not been given. Even if your child has been immunized, if these symptoms appear, call 911. Luckily, because of today's immunizations, this infection is rare.
American Academy of Pediatrics. 2003 Red Book Report on the Committee of Infectious Diseases (Amerian Academy of Pediatrics Committee on Infections Diseases//Report of the Committee on Infections Diseases)