Jan 31, 2012

Network Security Projects Using Honeypots



Honeypots are closely monitored decoys that are employed in a network to study the trail of hackers and to alert network administrators of a possible intrusion. Using honeypots provides a cost-effective solution to increase the security posture of an organization. Even though it is not a solution for security breaches, it is useful as a tool for network forensics and intrusion detection. Nowadays, they are also being extensively used by the research community to study issues in network security, such as Internet worms, spam control, DoS attacks and many more.

According to Bruce Schneier in Digital Security in a Networked World book, “Security is a process, not a product.” This famous quote is well echoed by the phenomenon that, although there exist umpteen numbers of security tools that are available today (either as commercial or open-source solutions), none of these tools can single-handedly address all of the security goals of an organization. The security professionals are thus looking for more advanced tools which are effective in detecting and recovering from security breaches. In order to monitor the activities of hackers, the methodology adopted is to deceive, by giving them some emulated set of services on a system which appears to be legitimate. The hackers’ activities are then logged and monitored to gain insight into their employed tactics. This idea is adopted in honeypots, a system whose value lies in being probed, attacked and/or compromised.

Honeypots have received a lot of attention lately from the research community , owing to its use in capturing and logging suspicious networking activities. Apart from its use as a research tool, it has also been deployed in educational institutions as a study tool. For example, the Honeynet Project at Georgia Tech has been used in network security classes in order to teach students how to use tools such as ethereal and tcpdump in order to analyze attack traffic. However, the problem with deploying such a honeypot inside a campus network is twofold. First, the installation of honeypot is quite risky and must be carried out with utmost precision and care, so that the campus network is not intruded. Secondly, legal and ethical issues (such as the Wiretap Act 18 U.S.C. 2511) must be taken care of before such a network is deployed.

Honeypots are generally divided into two categories: production honeypots and research honeypots. Production honeypots add value to the security of a specific organization and help mitigate risks, and are typically implemented within an organization as they help in detecting attacks. Production honeypots are easier to build and deploy, because they require less functionality. They give less information about the attackers than research honeypots. Research honeypots are designed to gain information about the blackhat community. The primary goal is to analyze the hackers’ footprints, such as the identity of the attackers, their modus operandi, and the kind of tools they use to attack other systems.

Based on their level of interaction, honeypots are classified into three categories: low interaction, medium interaction and high interaction honeypots. Low interaction honeypots are primarily production honeypots that are used to help protect a specific organization . A low interaction honeypot is easy to install and it emulates very few services. Attackers can only scan and connect to several ports. The information about the attackers and the risk is limited since the attacker’s ability to interact with the honeypot is limited.

An example of low interaction honeypots is "Honeyd" . Honeyd is a small daemon that creates virtual hosts on a network. The hosts can be configured to run arbitrary services, and their personality can be adapted so that they appear to be running certain operating systems. Honeyd works on the principle that when it receives a probe or connection for a system that does not exist, it assumes that the connection attempt is an attack. When honeyd receives such traffic, it logs the IP address of the destination. It then starts the emulated service for the port on which it receives the connection. Once the emulated service is started, it interacts with the attacker and captures all of his activities. The emulated service exits as soon as the attacker disconnects. This process is repeated each time honeyd receives attacks.
In Honeyd, a virtual honeypot is configured with a template created in the Honeyd configuration file (honeyd.conf) that defines the characteristics of a honeypot, including operating system type, the ports it listens on, and the behavior of emulated services. Each template is given a name. New templates are created using create command. The set command assigns a personality from Nmap fingerprinting file to the template. The personality determines the network behavior of the given operating system that is simulated by Honeyd. The set command also defines the default behavior for network protocols: block, reset or open. Block indicates that all packets for the specified protocol are dropped by default. Reset means that ports are closed by default. Open means that all ports are open by default. The add command is used to specify the services that are remotely accessible.

High interaction honeypots give vast amount of information about the attackers, but they are extremely time-consuming to build and maintain, and they come with highest level of risk . The primary goal of high interaction honeypot is to give the attacker access to a real operating system in which nothing is emulated or restricted. This provides more information about attackers. These types of honeypots are placed within a controlled environment such as behind a firewall. Because of the control mechanisms, high interaction honeypots can be difficult and time-consuming to install and configure. An example of high interaction honeypots is ‘Honeynet’. What makes a Honeynet different from most honeypots is that it is an entire network of systems. Instead of a single computer, a Honeynet is a network of systems designed for attackers to interact with. The honeypots within the Honeynet can be any type of system, service, or information.

Medium interaction honeypots offer attackers more ability to interact than low interaction honeypots but less functionality than high interaction honeypots . This type of honeypots are designed to give certain predefined responses for expected activities, and provide more information about the attacker than a low interaction honeypot.

Honeypots can be a good tool and can be used as a prototype for computer security lab and design of network security projects. The design of lab exercises for a network security lab is a challenging issue, and researcher need to design a good framework for such projects. The framework describes the issues that must be considered at the time of designing projects for computer or network security labs, and may be considered as a starting point by computer science educators wishing to design computer security projects. Honeypots can be a good tool for students to learn about Networking Security and the blackhat community. The virtual Honeynet was initially closed to the Internet due to concerns of ethical and legal issues, but was eventually open to the Internet world, in order to collect research data about the blackhat community. The collected data and their subsequent analysis helped us to protect our network from attackers.

Jan 25, 2012

Annoying phone call



Looking one of those:

Annoying phone call



Whose Call me


Phone number searching


Scam Phone number Malaysia


List of telemarketers/suspicious phone numbers to block and avoid
Text messages
22001 (Maxis. Aggressive spammers.)
26363 (Maxis. Aggressive spammers.)
Prefix 03
03-2026-7949 (Scammers; Added 14 Oct. 2011)
03-2027-4890 (Calls then hangs up; Added 14 Oct. 2011)
03-2034-0777 (AIA Insurance)
03-2035-3101 (AEON; Added 14 Oct. 2011)
03-2035-3734 (Calls then hangs up)
03-2035-4340 (Scammers; Added 10 Nov. 2011)
03-2035-7230 (Credit card – contributed by koi; Added 09 Dec. 2011)
03-2035-7732 (AEON credit card; Added 02 Nov. 2011)
03-2036-6XXX (Generic – will sell everything and anything. Aggressive.)
03-2036-7188 (General telemarketer; Added 09 Dec. 2011)
03-2037-1333 (AIA Insurance)
03-2037-1500 (AIA Insurance; Added 02 Nov. 2011)
03-2037-1666 (AIA Insurance. Aggressive.)
03-2050-3800 (HSBC; Added 10 Nov. 2011) 0320503800
03-2050-5300 (HSBC; Added 10 Nov. 2011)
03-2050-6300 (HSBC)
03-2052-1435 (Unknown – Credit card?)
03-2053-5200 (Scammers/Prank; Added 09 Dec. 2011)
03-2053-5200 (Also now Aeon debt collecter or claim to be - becarefull Added 2013)
03-2054-3000 (Calls then hangs up – Maybank?; Added 09 Dec. 2011)
03-2054-4672 (AIA Insurance)
03-2054-5400 (Ambank loan; Added 02 Nov. 2011)
03-2056-0838 (AirAsia; Added 14 Oct. 2011)
03-2058-3688 (AEON credit card; Added 09 Dec. 2011)
03-2058-4000 (HSBC)
03-2059-9000 (HSBC)
03-2059-9600 (HSBC)
03-2061-4600 (Calls then hangs up; Added 02 Nov. 2011)
03-2146-7000 (Debt collectors; Added 09 Dec. 2011)
03-2167-6267 (Ambank loan; Added 09 Dec. 2011)
03-2167-7400 (MBF; Added 02 Nov. 2011)
03-2170-4XXX (Generic – will sell everything and anything. Aggressive.)
03-2167-7722 (Scammers; Added 09 Dec. 2011)
03-2170-9400 (Hong Leong Bank)
03-2172-1000 (Calls then hangs up; Added 09 Dec. 2011)
03-2175-4999 (Palace of the Golden Horses/Mines)
03-2176-4888 (Job/Head hunter)
03-2179-6600 (Public bank; Contributed by Nicole; Added 12 Jan. 2012)
03-2182-2600 (Insurance? Added 09 Dec. 2011)
03-2182-7600 (CIMB; Added 10 Nov. 2011)
03-2203-6000 (CIMB; Added 09 Dec. 2011)
03-2252-4408 (Maybank credit card; Added 03 Nov. 2011)
03-2260-3702 (SMS Service by Radins-ED Sdn. Bhd.; Corrected 10 Nov. 2011)
03-2261-4699 (Scammers)
03-2264-7999 (Debt collectors, P&A Smart Solution; Added 09 Dec. 2011)
03-2266-2222 (ALERT! Scammers, hijacking Bukit Aman Police number; Updated 09 Dec. 2011)
03-2296-2000 Annoying - Marketing(Feb 2012)(Scammers; Added 02 Nov. 2011)
02-2297-7700 (Scammers; Added 03 Nov. 2011)
03-2332-6650 (Scammers)
03-2332-6927 (Debt collectors)
03-2332-6995 (Scammers; Added 12 Jan. 2012)
03-2333-1100 (Citibank; Added 02 Nov. 2011)
03-2383-1100 (Citibank credit card; Added 09 Dec. 2011)
03-2383-4000 (Citibank; Added 12 Jan. 2012)
03-2383-8585 (Citibank; Added 09 Dec. 2011)
03-2600-9199 (Celcom package promotion; Added 12 Jan. 2012)
03-2600-9200 (Unknown – Insurance?) - this no from AIA Insurance Promote Insurance Under Telekom (update 1 june 2012)
03-2601-4400 (Calls then hangs up)
03-2601-6400 (TM Malaysia; Added 12 Jan. 2012)
03-2610-5030 (AEON credit card; Added 09 Dec. 2011)
03-2612-8400 (Maybank credit card; Added 02 Nov. 2011)
03-2614-3566 (CIMB Insurance; Added 10 Nov. 2011)
03-2616-3999 (Scammers)
03-2619-4300 (CIMB loan; Added 09 Dec. 2011)
03-2688-6000 (AEON credit card; Added 12 Jan. 2012)
03-2690-9500 (HSBC; Added 02 Nov. 2011)
03-2718-4275 (Scammers)
03-2719-2600 (General telemarketer; Added 12 Jan. 2012)
03-2179-6600 (Calls then hangs up; Added 09 Dec. 2011)
03-2719-6800 (General telemarketer; Added 09 Dec. 2011)
03-2722-5700 (AIA)
03-2722-5678 (General telemarketer; Added 09 Dec. 2011)
03-2727-5000 (Generic – will sell everything and anything . Aggressive; Added 02 Nov. 2011)
03-2727-8068 (Unknown  but annoying)
03-2727-8098 (Unknown  but annoying) Received a call from a lady from this number claiming she from Hong Leong Bank asking for banking & credit card details but she is not from HLB. This matter has been reported to HL Bank. Police Report to follow. Please be very careful everybody. - update July 2014
03-2727-8029 (Unknown  but annoying)

03-2770-0001 (Scammers; Added 10 Nov. 2011)
03-2772-0300 (Maybank)
03-2772-7300 (Scammer; Added 14 Oct. 2011)
03-2772-7500 (Maybank credit card; Added 12 Jan. 2012)
03-2773-0300 (Hong Leong Bank; Added 10 Nov. 2011)
03-2773-3113 (Calls then hangs up)
03-2773-3999 (Standard Chartered Malaysia Bank)
03-2776-3900 (Maybank)
03-2781-1XXX (Debt collectors; Added 14 Oct. 2011)
03-2781-3100 (Telemarketer for banks; Added 12 Jan. 2012)
03-2781-8181 (AIA; Added 09 Dec. 2011)
03-2782-6998 (Scammers; Added 09 Dec. 2011)
03-2787-1000 (Calls then hangs up; Added 09 Dec. 2011)
03-2787-4000 (Some property developer; Added 14 Oct. 2011)
03-2787-4200 (General telemarketer for insurance; Added 09 Dec. 2011)
03-2847-2400 (Celcom)
03-2848-7200 (Celcom bill collection; Added 02 Nov. 2011)
03-3372-2517 (TM Unifi; Added 02 Nov. 2011)
03-4024-0418 (Scammer; Added 02 Nov. 2011)
03-4041-5773 (HSBC)
03-4044-3860 (Debt collectors; Added 09 Dec. 2011)
03-4044-3862 (HSBC debt collectors; Added 10 Nov. 2011)
03-4044-3897 (HSBC debt collectors; Added 10 Nov. 2011)
03-4044-3962 (HSBC debt collectors; Added 10 Nov. 2011)
03-4044-3901 (HSBC debt collectors; Added 10 Nov. 2011)
03-4044-3984 (Debt collectors; Added 09 Dec. 2011)
03-4044-3986 (HSBC debt collectors; Added 10 Nov. 2011)
03-4044-4014 (HSBC debt collectors; Corrected 10 Nov. 2011)
03-4044-4018 (Debt collectors; Added 09 Dec. 2011)
03-4044-4031 (Debt collectors; Added 09 Dec. 2011)
03-4044-4492 (Debt collectors; Added 09 Dec. 2011)
03-4050-2311 (Hong Leong Assurance; Added 14 Oct. 2011)
03-4141-4141 (Debt collectors; Added 09 Dec. 2011)
03-4142-5258 (Debt collectors; Added 09 Dec. 2011)
03-4142-7094 (Scammers; Added 12 Jan. 2012)
03-4148-1053 (Takaful; Added 03 Nov. 2011)
03-5515-1752 (TM Streamyx debt collection; Added 02 Nov. 2011)
03-5517-1188 (Debt collectors for various telcos; Added 10 Nov. 2011)
03-5518-3987 (Debt collectors for various telcos; Added 10 Nov. 2011)
03-5518-3988 (Debt collectors for various telcos; Added 10 Nov. 2011)
03-5542-1088 (Debt collectors for various telcos; Added 10 Nov. 2011)
03-5623-8000 (Affin Bank loan; Added 02 Nov. 2011)
03-5721-7788 (Digi debt collection; Added 10 Nov. 2011)
03-5885-5100 (Maybank)
03-5885-5300 (Maybank)
03-6254-5999 (Debt collectors; Added 02 Nov. 2011)
03-6254-7399 (Debt collectors, Sharif Partners; Updated 09 Dec. 2011)
03-7494-1666 (Debt collectors, Credit Risk Management; Added 09 Dec. 2011)
03-7494-5000 (Astro)
03-7494-5400 (Astro; Added 02 Nov. 2011)
03-7626-1800 (Calls then hangs up; Added 12 Jan. 2012)
03-7626-8899 (Hong Leong bank; Added 12 Jan. 2012)
03-7629-2007 (Prank or Scammer; Added 02 Nov. 2011)
03-7650-1288 (Hong Leong Assurance; Added 03 Nov. 2011)
03-7651-5500 (AIA Insurance; Added 02 Nov. 2011)
03-7663-7000 (Calls then hangs up; Added 09 Dec. 2011)
03-7650-1818 (Hong Leong insurance; Added 09 Dec. 2011)
03-7651-5000 (Astro; Added 12 Jan. 2012)
03-7651-6100 (Calls then hangs up; Added 12 Jan. 2012)
03-7712-2356 (One World 1Utama Club)
03-7787-5200 (Astro)
03-7787-5600 (Astro; Added 12 Jan. 2012)
03-7797-5200 (Astro)
03-7841-5888 (Enfa Club Member; Added 14 Oct. 2011)
03-7841-6800 (Calls then hangs up; Added 09 Dec. 2011)
03-7844-3500 (Maybank; Added 12 Jan. 2012)
03-7849-1XXX (Generic – will sell everything and anything. Aggressive.)
03-7862-2111 (Calls then hangs up; Added 12 Jan. 2012)
03-7862-2133 (AIG Insurance; corrected 07 Nov. 2011)
03-7862-5622 (Credit card? Added 03 Nov. 2011)
03-7862-5656 (AIA Insurance)
03-7862-5680 (Credit card? Added 03 Nov. 2011)
03-7872-8686 (Debt collectors)
03-7872-8700 (Debt collectors; Added 09 Dec. 2011)
03-7873-6915 (Debt collectors)
03-7885-8835 (Debt collectors; Added 02 Nov. 2011)
03-7885-8904 (Celcom; Added 02 Nov. 2011)
03-7946-3333 (Astro)
03-7948-6000 (Debt collectors, Legal Recovery Agency; Added 12 Jan. 2012, TM Debt Collector Update 01 June 2012)
03-7950-1111 (Hong Leong; Added 09 Dec. 2011)
03-7950-1133 (Hong Leong Bank)
03-7962-9200 (Allianz Insurance)
03-7964-9600 (CIMB-Air Asia; Added 03 Nov. 2011)
03-8073-7699 (Alliance Bank; Added 02 Nov. 2011)
03-8213-2000 (Scammers; Added 12 Jan. 2012)
03-9027-7200 (Telemarketer for insurance; Added 09 Dec. 2011)
03-9173-3382 (EON Bank)
03-9207-7277 (Prudential Insurance. Aggressive; Added 02 Nov. 2011)
03-9200-9055 (AmBank Debt Collector)
03-9200-2066 (Ambank Debt Collector)
03-9235-3600 (Fitness First membership promotion; Added 09 Dec. 2011)
03-9543-6110 (Calls then hangs up; Added 12 Jan. 2012)
03-9543-6140 (Scammers)
03-9543-6170 (Scammers)
Prefix 07
07-556-1222 (Scammers; Added 03 Nov. 2011)
Prefix 010
010-204-9408 (Scammers)
010-934-7527 (Scammers)
010-953-0682 (Scammers)
Prefix 012
012-203-8401 (Caryn, EON Bank)
012-262-4598 (Maybank; Added 03 Nov. 2011)
012-263-2049 (Pusat Perubatan Wanita Petaling Jaya)
012-266-3791 (Dairy Farm Malaysia)
012-333-6038 (Astro)
012-349-4366 (Usahawan Lumiglow)
012-353-0225 (Scammers) Received 30,000 "blank" sms from this number day and nite over a period of 1 month. Neither Digi nor Maxis could find out who this number belongs to. Police report made. update - July 2014 012-357-0621 (Alliance Bank)
012-387-7235 (Mines Wellness Centre)
012-527-8353 (Scammers)
012-606-2671 (Astro)
012-662-1283 (Astro)
012-721-3041 (Scammers; Added 09 Dec. 2011)
012-778-8514 (Scammers; Added 09 Dec. 2011)
012-823-4137 (Scammers)

Prefix 013
013-213-4196 (Takaful)
013-213-4220 (Chandra, Takaful; Added 03 Nov. 2011)
013-335-1460 (Farah, Titan Group Sdn Bhd)
013-363-6536 (Usahawan Lumiglow)
Prefix 014
014-374-8521 (Scammers)
014-711-3084 (Scammers; Added 09 Dec. 2011)
014-727-3273 (Debt collectors for various telcos; Added 10 Nov. 2011)
014-727-3274 (Debt collectors for various telcos; Added 10 Nov. 2011)
014-727-3281 (Debt collectors for various telcos; Added 10 Nov. 2011)
014-728-1288 (Hong Leong Assurance; Added 03 Nov. 2011)
014-728-3088 (Takaful; Added 03 Nov. 2011)
014-728-3323 (Standard Chartered Bank; Added 03 Nov. 2011)
014-728-8601 (Ambank Debt Collector)
Prefix 016
016-201-4884 (Scammers; Added 03 Nov. 2011)
016-211-2352 (Ambank)
016-211-7917 (Scammers; Added 03 Nov. 2011)
016-216-0736 (Takaful; Added 03 Nov. 2011)
016-216-4702 (Ambank; Added 12 Jan. 2012)
016-226-7544 (Spammer; Added 03 Nov. 2011)
016-227-7184 (Maybank; Added 03 Nov. 2011)
016-256-0863 (Scammers; Added 03 Nov. 2011)
016-261-6048 (Card Center KL)
016-262-2157 (Tourism Malaysia)
016-262-2247 (Spammers)
016-262-7544 (Credit card? Added 03 Nov. 2011)
016-262-7650 (Spammers; Added 03 Nov. 2011)
016-262-7653 (Vacation Club; Added 03 Nov. 2011)
016-262-7654 (Credit card? Added 03 Nov. 2011)
016-263-1277 (Spammers)
016-320-2731 (Scammers; Added 03 Nov. 2011)
016-332-3864 (Vacation Club; Added 03 Nov. 2011)
016-335-2189 (Scammers; Added 03 Nov. 2011)
016-335-8630 (Michelle, Cabinet promotion)
016-336-4087 (Scammers; Added 03 Nov. 2011)
016-337-5627 (Leisure Holiday)
016-336-6650 (Lady caller. Prank calls looking for information to scam, Added 4 April 2012)
016-339-7020 (Credit card – contributed by koi; Added 09 Dec. 2011)
016-626-3171 (Scammers; Added 03 Nov. 2011)
016-626-3397 (Scammers; Added 03 Nov. 2011)
016-626-6394 (Scammers; Added 03 Nov. 2011)
016-648-4724 (Spammers)
016-655-7841 (Debt collectors; Added 09 Dec. 2011)
016-712-3427 (Scammers; Added 03 Nov. 2011)
016-979-2307 (Spammers)
Prefix 017
017-207-4859 (Debt collectors; Added 09 Dec. 2011)
017-218-6523 (Debt collectors; Added 09 Dec. 2011)
Prefix 018
018-278-4955 (Al-Rajhi Bank)
018-667-2455 (Al-Rajhi Bank)
Prefix 019
019-335-2189 (Scammers; Added 03 Nov. 2011)
From overseas (contacting us in Malaysia)
1-610-222-6009 (Unknown – USA)
44-77-3003-9225 (Scammers – UK)
44-77-3044-6195 (Scammers – UK)
852-6067-4175 (Scammers – Hong Kong; Added 09 Dec. 2011)
Please remember to contact me (using the comment below or Contact option above) to let me know more nuisance telemarketers numbers, and I will add them here, crediting you if you wish.


Jan 15, 2012

TOP 10 US JOB



10. Lawyers

Pay: $110,590












9. Airline Pilots

Pay: $111,680











8. Air Traffic Controllers

Pay: $111,870






7. Computer and Information Systems Managers

Pay: $112,210








6. Natural Science Managers


Pay: $112,800








5. Podiatrists

Pay: $113,560




Podiatrists are also known as Doctors of Podiatric Medicine (DPMs). These are the people who diagnose and treat disorders, diseases and injuries of foot and lower legs. For becoming a Podiatrist, you need a Bachelor’s degree in Science or have to attend a medical school for four years.





4. Engineering Managers

Pay: $115,270







3. Dentists

Pay: $142,870








2. Chief Executive Officers

Pay: $158,560






1. Physicians and Surgeons


Pay: $166,400




Physicians and Surgeons are the people who diagnose illnesses and treat diseases. To become one, a Bachelor’s in Science (Biology or Chemistry) or attending medical school for four years is required. MCAT is the test which is a must for consideration, 3 to 8 years of Internship/Residency.



Jan 14, 2012

Croup





Croup is breathing difficulty accompanied by a "barking" cough. Croup, which is swelling around the vocal cords, is common in infants and children and can have a variety of causes.

Causes, incidence, and risk factors

Viral croup is the most common. Other possible causes include bacteria, allergies, and inhaled irritants. Acid reflux from the stomach can trigger croup.

Croup is usually (75% of the time) caused by parainfluenza viruses, but RSV, measles, adenovirus, and influenza can all cause croup.

Before the era of immunizations and antibiotics, croup was a dreaded and deadly disease, usually caused by the diphtheria bacteria. Today, most cases of croup are mild. Nevertheless, it can still be dangerous.

Croup tends to appear in children between 3 months and 5 years old, but it can happen at any age. Some children are prone to croup and may get it several times.

In the northern hemisphere, it is most common between October and March, but can occur at any time of the year.

In severe cases of croup, there may also be a bacterial superinfection of the upper airway. This condition is called bacterial tracheitis and requires hospitalization and intravenous antibiotics. If the epiglottis becomes infected, the entire windpipe can swell shut, a potentially fatal condition called epiglottitis.



Symptoms

Croup features a cough that sounds like a seal barking. Most children have what appears to be a mild cold for several days before the barking cough becomes evident. As the cough gets more frequent, the child may have labored breathing or stridor (a harsh, crowing noise made during inspiration).

Croup is typically much worse at night. It often lasts 5 or 6 nights, but the first night or two are usually the most severe. Rarely, croup can last for weeks. Croup that lasts longer than a week or recurs frequently should be discussed with your doctor to determine the cause.



Signs and tests

Children with croup are usually diagnosed based on the parent's description of the symptoms and a physical exam. Sometimes a doctor will even identify croup by listening to a child cough over the phone. Occasionally other studies, such as x-rays, are needed.

A physical examination may show chest retractions with breathing. Listening to the chest through a stethoscope may reveal prolonged inspiration or expiration, wheezing, and decreased breath sounds.

An examination of the throat may reveal a red epiglottis. A neck x-ray may reveal a foreign object or narrowing of the trachea.



Treatment

Most cases of croup can be safely managed at home, but call your health care provider for guidance, even in the middle of the night.

Cool or moist air might bring relief. You might first try bringing the child into a steamy bathroom or outside into the cool night air. If you have a cool air vaporizer, set it up in the child's bedroom and use it for the next few nights.

Acetaminophen can make the child more comfortable and lower a fever, lessening his or her breathing needs. Avoid cough medicines unless you discuss them with your doctor first.

You may want your child to be seen. Steroid medicines can be very effective at promptly relieving the symptoms of croup. Medicated aerosol treatments, if necessary, are also powerful.

Serious illness requires hospitalization. Increasing or persistent breathing difficulty, fatigue, bluish coloration of the skin, or dehydration indicates the need for medical attention or hospitalization.

Medications are used to help reduce upper airway swelling. This may include aerosolized racemic epinephrine, corticosteroids taken by mouth, such as dexamethasone and prednisone, and inhaled or injected forms of other corticosteroids. Oxygen and humidity may be provided in an oxygen tent placed over a crib. A bacterial infection requires antibiotic therapy.

Increasing obstruction of the airway requires intubation (placing a tube through the nose or mouth through the larynx into the main air passage to the lungs). Intravenous fluids are given for dehydration. In some cases, corticosteroids are prescribed.



Expectations (prognosis)

Viral croup usually goes away in 3 to 7 days. The outlook for bacterial croup is good with prompt treatment.

If an airway obstruction is not treated promptly, respiratory distress (severe difficulty breathing) and respiratory arrest can occur.



Complications

  • Respiratory distress
  • Respiratory arrest
  • Epiglottitis
  • Bacterial tracheitis
  • Atelectasis (collapse of part of the lung)
  • Dehydration

Calling your health care provider

Most croup can be safely managed at home with telephone support from your health care provider. Call emergency line if:

  • The croup is possibly being caused by an insect sting or inhaled object
  • The child has bluish lips or skin color
  • The child is drooling
  • The child is having trouble swallowing



Depending on the severity of the symptoms, call emergency hotline or your health care provider for any of the following:

  • Stridor (noise when breathing in)
  • Retractions (tugging-in between the ribs when breathing in)
  • Struggling to breathe
  • Agitation or extreme irritability
  • Not responding to home treatment
  • Do NOT wait until morning to address the problem.

Prevention

  • Wash your hands frequently and avoid close contact with those who have a respiratory infection.
  • The diphtheria, Haemophilus influenzae (Hib), and measles vaccines protect children from some of the most dangerous forms of croup.



References

Hall CB, McBride JT. Acute laryngotracheobronchitis (croup). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 56.

Everard ML. Acute bronchiolitis and croup. Pediatr Clin North Am. 2009;56(1):119-133. [PubMed: 19135584]

Roosevelt GE. Acute inflammatory upper airway obstruction (croup, epiglottitis, laryngitis, and bacterial tracheitis). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 382.


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