Is a recurrent barky cough a sign of viral infection?

Question

Hello doctor,

My three-and-a-half-year-old son has had four mild viral illnesses in the last five months that included an occasional barky cough and, when upset, a barky cry.

In between the barky cough episodes, his cough sounds normal. He almost never has stridors at rest. It seems to be viral, with a runny nose and cough that turns into a croup-like illness. He can also develop a hoarse voice. He breathes normally during play and activity.

How do I know if this is true croup or just a mild viral illness with vocal cord irritation?
Is this something we need to investigate further?

We saw an ENT specialist, and they were not concerned. They were unable to perform a flexible laryngoscopy because my child did not cooperate.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

From the history you have provided, it points toward laryngotracheal inflammation, which is often secondary to viral infections. The fact that the cough alternates with a normal cough in between episodes also supports milder airway inflammation.

Typical mild croup usually begins with common cold symptoms such as a runny nose and mild cough, and the symptoms are often worse at night. In most uncomplicated viral croup cases, symptoms usually improve over several days.

In more concerning airway disorders, persistent and often progressive stridor may be present, along with noisy breathing even at rest. It may also be associated with recurrent pneumonia, poor growth, or feeding difficulties.

Recurrent croup is fairly common in children between six months and five years of age because their airways are naturally narrower. Further evaluation should be considered if the episodes become severe or frequent.

Instead of oral Dexamethasone, nebulized Budesonide can also be considered, especially in recurrent cases, as it acts locally and helps decrease inflammation.

As far as laryngoscopy is concerned, children of this age may not tolerate the procedure well. However, it should be considered if the symptoms become severe or refractory to treatment.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.