A ten month old recently had a mild URI. Over the next couple of days, he develops a “barky cough” with intermittent stridor which is worse at night. He has a low grade fever. Crying seems to exacerbate the stridor. This history is most consistent with:
a. epiglottitis
b. aspiration of a foreign body
c. a “thumb print” sign on lateral xray of the neck.
d. a “steeple sign” on AP neck film
Chris Paul
The symptoms described—barky cough, intermittent stridor worse at night, low-grade fever, and worsening with crying—are consistent with:
d. a “steeple sign” on AP neck film
The “steeple sign” is indicative of croup, which is a common condition in young children characterized by viral inflammation of the upper airway. It typically presents with a “barky” cough, stridor, and symptoms worsening at night.