Differential Diagnosis for Viral URI with Barking Cough, Stridor, and Hoarse Voice
- Single Most Likely Diagnosis
- Croup (Laryngotracheobronchitis): This condition is characterized by a barking cough, stridor, and hoarse voice, typically seen in children. It is most commonly caused by the parainfluenza virus, but other viruses like influenza, adenovirus, and respiratory syncytial virus (RSV) can also be responsible. The symptoms match closely with the presentation described.
- Other Likely Diagnoses
- Influenza: While influenza typically presents with fever, cough, and body aches, some cases can lead to complications like laryngitis, which might cause a hoarse voice. However, the barking cough and stridor are less common.
- Adenovirus Infection: Adenoviruses can cause a range of respiratory symptoms, including those similar to croup, especially in children. They can lead to laryngitis and pharyngitis, which might result in a hoarse voice.
- Do Not Miss Diagnoses
- Epiglottitis: Although more commonly associated with bacterial infections (like Haemophilus influenzae type b, though vaccination has reduced its incidence), viral epiglottitis can occur. It presents with severe sore throat, difficulty swallowing, and can lead to respiratory distress. The potential for airway obstruction makes it critical not to miss.
- Retropharyngeal Abscess: This condition, often secondary to a bacterial infection, can cause severe throat pain, difficulty swallowing, and respiratory distress due to the mass effect of the abscess. While not typically viral in origin, the initial infection leading to the abscess could be viral.
- Rare Diagnoses
- Herpangina: Caused by coxsackieviruses, this condition leads to small, painful blisters on the roof of the mouth and the back of the throat. It can cause a sore throat but is less likely to cause a barking cough or stridor.
- Pertussis (Whooping Cough): Although primarily known for its whooping sound during coughing fits, pertussis can sometimes present atypically, especially in vaccinated individuals or adults. However, the classic whoop and post-tussive vomiting are more characteristic than a barking cough or stridor.