Differential Diagnosis for Sudden Onset Barking Cough in a 3-Year-Old Without Fever
- Single Most Likely Diagnosis
- Croup: This is the most likely diagnosis due to the characteristic barking cough, which is a hallmark symptom of croup. Croup is a common childhood illness that typically affects children between 6 months and 5-6 years old, often without fever in the early stages.
- Other Likely Diagnoses
- Acute bronchiolitis: Although more commonly associated with wheezing, some cases of bronchiolitis can present with a cough that may sound barking, especially in younger children. The absence of fever does not rule out this diagnosis.
- Foreign body aspiration: This can cause sudden onset of coughing and may lead to a barking sound if the object is lodged in the trachea. The lack of fever does not exclude this possibility.
- Allergic reaction or acute allergic laryngitis: Though less common, an allergic reaction could potentially cause sudden onset of a barking cough without fever.
- Do Not Miss Diagnoses
- Epiglottitis: Although less common in the era of widespread vaccination against Haemophilus influenzae type b (Hib), epiglottitis is a life-threatening condition that can present with sudden onset of a severe cough, among other symptoms. The absence of fever does not rule out this diagnosis.
- Retropharyngeal abscess: This condition can cause severe respiratory distress and may present with a change in voice or cough. It is crucial to consider this diagnosis due to its potential for airway compromise.
- Rare Diagnoses
- Subglottic stenosis: This condition can cause a barking cough due to narrowing of the subglottic airway. It is less common and might be considered if other diagnoses are ruled out.
- Laryngomalacia or other congenital anomalies of the larynx: These conditions might cause chronic or recurrent symptoms but could potentially present acutely if there's an exacerbating factor.
- Inhaled irritants or smoke: Exposure to certain irritants could cause a sudden onset of coughing, potentially with a barking quality, depending on the substance and the individual's response.