Differential Diagnosis for Barking Cough in a 2-Year-Old
- Single Most Likely Diagnosis
- Croup: This is the most common cause of a barking cough in children, especially in those under the age of 5. It is characterized by a hoarse voice, barking cough, and stridor, often worse at night. The condition is usually viral in nature and self-limiting.
- Other Likely Diagnoses
- Acute bronchiolitis: Although more commonly associated with wheezing, some children with bronchiolitis may present with a cough that can sound similar to a barking cough, especially if there is significant airway inflammation.
- Pneumonia: Certain types of pneumonia, especially those caused by viral pathogens or Mycoplasma pneumoniae, can present with a cough that may be described as barking, along with other symptoms like fever and difficulty breathing.
- Foreign body aspiration: While less common, aspiration of a foreign body can cause sudden onset of cough, which might be described as barking, especially if the object is lodged in the trachea or a main bronchus.
- Do Not Miss Diagnoses
- Epiglottitis: This is a life-threatening condition that requires immediate medical attention. It can present with a severe sore throat, difficulty swallowing, high fever, and a muffled voice, but in some cases, a barking cough may be an early symptom.
- Retropharyngeal abscess: Although rare, this condition can cause severe respiratory distress and may present with a barking cough, along with difficulty swallowing, neck stiffness, and high fever.
- Rare Diagnoses
- Subglottic stenosis: A congenital or acquired narrowing of the subglottic airway can cause respiratory symptoms, including a barking cough, especially during episodes of upper respiratory infection.
- Tracheitis: Bacterial tracheitis is a rare but serious condition that can cause severe cough, often described as barking, along with high fever, stridor, and significant respiratory distress.
- Laryngomalacia: While typically presenting in infancy, some cases of laryngomalacia may not be diagnosed until later, and can cause a variety of respiratory symptoms, including a barking cough, especially during feeding or when lying on the back.