Regarding croup, which statement is true?

• A. Croup is treated with antibiotics.
• B. Croup occurs in older children.
• C. Croup is benign.
• D. Symptoms such as barking cough and inspiratory stridor often worsen at night.

Answer: (D)

Viral croup presents with a barking cough and inspiratory stridor from narrowing of the larynx and trachea. A hallmark feature many clinicians test is that symptoms often worsen at night. Nighttime flare-ups happen because airway inflammation and edema can feel more pronounced when the child is resting; cooler, drier nighttime air can also irritate the already inflamed airway, making stridor and coughing more noticeable. This nocturnal pattern helps distinguish croup from conditions that don’t typically worsen after sunset. Since croup is usually viral, antibiotics aren’t indicated unless a different bacterial infection is suspected, and the illness is typically self-limited, though it can range from mild to more severe requiring corticosteroids and, in some cases, aerosolized epinephrine for significant airway obstruction.