A child with croup typically presents with which of the following?

• A. Barking cough and inspiratory stridor, often worse at night.
• B. Wheezing with productive cough.
• C. Fever without cough.
• D. Rash on trunk.

Answer: (A)

This question hinges on recognizing the classic presentation of croup, an upper airway infection that causes subglottic edema. The hallmark signs are a barking or seal-like cough and inspiratory stridor from airway narrowing just below the vocal cords. This combination occurs because the swollen area makes it harder for air to flow in during inspiration, producing the characteristic high-pitched noise, and the irritation in the larynx leads to the bark-like cough. Symptoms are often worse at night, when airway cooling and edema can intensify and the child is more upright or supine. Most children with mild croup have a low-grade fever and hoarseness, and the overall picture is distinct from lower airway diseases.

Wheezing with a productive cough points more toward bronchiolitis or bronchitis, not croup. Fever without cough is not typical of croup, and a trunk rash suggests a different illness altogether.