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Barking cough and stridor in a child
Paediatrics · exam-style practice question with explanation
A 2-year-old has a barking cough, a hoarse voice and inspiratory stridor after two days of a runny nose. What is the most likely diagnosis?
- A. Epiglottitis
- B. Croup (laryngotracheobronchitis)
- C. Bronchiolitis
- D. Inhaled foreign body
Show the answer and explanation
Answer: B. Croup (laryngotracheobronchitis)
Croup is usually caused by parainfluenza virus. It gives a barking, seal-like cough, a hoarse voice and stridor, typically in children aged 6 months to 3 years after a cold. Treat with a single dose of oral dexamethasone, and nebulised adrenaline if severe. Epiglottitis instead presents with a toxic child, drooling and no barking cough.
Key point: Croup: barking cough + stridor; give oral dexamethasone.
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