Differential Diagnosis for Barking Cough

• Single most likely diagnosis
  • Croup: This is the most common cause of a barking cough, especially in children. Croup is characterized by a hoarse voice, barking cough, and difficulty breathing due to inflammation of the larynx and trachea.
• Other Likely diagnoses
  • Pertussis (Whooping Cough): Although the cough is more typically described as a whoop, some patients may present with a barking quality to their cough. This diagnosis is more likely in unvaccinated or under-vaccinated individuals.
  • Tracheitis: Inflammation of the trachea can cause a barking cough, often accompanied by other symptoms like fever and difficulty breathing.
  • Bronchiolitis: While more commonly associated with wheezing, some cases of bronchiolitis, especially in young children, can present with a barking cough.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Epiglottitis: Although rare, epiglottitis is a life-threatening condition that can cause a barking cough, along with severe difficulty swallowing and breathing. Prompt recognition and treatment are crucial.
  • Foreign Body Aspiration: Aspiration of a foreign body can cause sudden onset of a barking cough, among other symptoms, and is a medical emergency.
• Rare diagnoses
  • Subglottic Stenosis: A narrowing of the subglottic airway can cause a barking cough, typically in the context of a history of intubation or other airway trauma.
  • Laryngomalacia: A condition where the tissues of the larynx are soft and floppy, which can cause partial airway obstruction and a barking cough, especially in infants.
  • Vascular Rings: Rare congenital anomalies where vascular structures compress the trachea or esophagus, potentially causing a barking cough among other symptoms.