During a physical examination, you notice a ‘barking’ cough in a child. What condition should you suspect?

A ‘barking’ cough in a child is a classical sign of croup, which is characterized by inflammation of the upper airways, often caused by viral infections. This condition primarily affects young children and can lead to narrowing of the airway, resulting in a distinctive cough that sounds like a seal barking. In addition to the barking cough, croup may be accompanied by stridor (a high-pitched wheezing sound) and respiratory distress, particularly when the child is agitated or lying down.

The other conditions listed have different cough characteristics and symptoms. For instance, bronchiolitis typically presents with wheezing and a more continuous course of cough rather than the specific barking quality of croup. Pneumonia often features a productive cough with signs of fever and a more systemic illness rather than the stridor and bark associated with croup. Asthma might present with wheezing and difficulty breathing, but not a barking cough. Therefore, the presentation of a barking cough strongly indicates croup as the likely diagnosis.