Differential Diagnosis for a 7-year-old with a Barking Cough
- Single most likely diagnosis:
- Croup: This is the most likely diagnosis due to the characteristic barking cough, which is often seen in children around this age. Croup is a common childhood illness that causes inflammation and narrowing of the airways, leading to the distinctive cough.
- Other Likely diagnoses:
- Viral laryngitis: This condition can also cause a barking cough, although it's less common than croup. It's an inflammation of the larynx (voice box) usually caused by a viral infection.
- Allergic rhinitis: Although not typically causing a barking cough, allergic rhinitis can lead to chronic cough and may be considered if the child has a history of allergies.
- Asthma: While asthma typically presents with wheezing, some children may have a cough-predominant asthma, which could be considered in the differential diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Epiglottitis: This is a life-threatening condition that requires immediate medical attention. Although it's less common in children who have been vaccinated against Haemophilus influenzae type b (Hib), it's crucial to consider due to its high mortality rate if not promptly treated.
- Foreign body aspiration: If the child has a history of choking or sudden onset of symptoms, foreign body aspiration should be considered, as it can cause significant airway obstruction and is a medical emergency.
- Pneumonia: Certain types of pneumonia, especially those caused by bacteria, can present with severe symptoms and require immediate antibiotic treatment.
- Rare diagnoses:
- Subglottic stenosis: A rare condition where the airway is narrowed, which could cause a barking cough. It's more common in children who have had prolonged intubation.
- Laryngeal papillomatosis: A rare condition caused by the human papillomavirus (HPV), leading to growths on the larynx that can cause a barking cough.
- Tracheitis: An inflammation of the trachea, which can be caused by bacterial or viral infections and may present with a barking cough, although it's less common.