Croup — DCH MCQ

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ModerateCommon childhood illnessesCroupDCH

A 2-year-old girl is brought to urgent care at night after 2 days of coryzal symptoms. She has developed a barking cough and inspiratory stridor when upset. She is alert, has oxygen saturations of 97% in air and mild subcostal recession, and is drinking normally. What is the most likely diagnosis?

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Correct answer: B — Viral croup

The most likely diagnosis is viral croup. A 2-year-old is in the typical age range, and the combination of a barking cough, inspiratory stridor when upset, nocturnal presentation, mild recession, preserved alertness and ability to drink is characteristic. Foreign body aspiration is usually abrupt, often with a choking episode, and does not typically cause a coryzal prodrome or classic barking cough. Epiglottitis is more likely with marked systemic illness, drooling, dysphagia and a muffled voice. Bacterial tracheitis usually causes fever, toxicity and progressive airway obstruction. Bronchiolitis is a lower-airway illness causing tachypnoea, wheeze and/or crackles rather than barking cough with inspiratory stridor.

Reference: Cambridge University Hospitals NHS Foundation Trust. Children’s Croup and Stridor. Approved 9 December 2025. https://www.cuh.nhs.uk/patient-information/childrens-croup-and-stridor/