A four-year old child is being evaluated in the emergency room for difficulty breathing and a fever. Upon arrival to the ER, the respiratory therapist notes the patient has a barking cough. CXR results reveal subglottic swelling with a steeple sign. The most likely diagnosis is?​

  1. Asthma
  2. Croup
  3. Epiglottitis
  4. Pneumonia

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2. Croup

Explanations

  1. Asthma is not associated with subglottic swelling or fever.

  2. Croup is associated with a barking cough, and subglottic swelling which may appear as a steeple. Though croup is caused by a viral infection, it is often accompanied by a fever.

  3. Epiglottitis is not associated with subglottic swelling and does not reveal a steeple sign on X-ray. Epiglottitis is associated with suptrglottic swelling and is associated with a thumb sign on X-ray.

  4. Pneumonia is not associated with subglottic swelling or a barking cough.

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