Which condition involves swelling around the vocal cords and a barking cough, commonly seen in children?

• A. Pertussis
• B. Croup
• C. Pneumonia
• D. Pneumothorax

Answer: (B)

Swelling around the vocal cords in a child leads to a narrowing of the upper airway, especially in the larynx and subglottic space, which produces a distinctive barking cough and often inspiratory stridor. This pattern is classic for croup (laryngotracheobronchitis) and is most common in young children after a viral upper respiratory infection. The hoarseness and the bark-like cough come from edema of the laryngeal tissues causing airflow limitation, particularly when the child is laid down or at night.

Other conditions don’t fit this presentation as neatly. Pertussis causes long, paroxysmal coughing fits that may end with a whoop, rather than a barking cough and stridor. Pneumonia usually presents with fever and signs of a lower respiratory infection, such as localized chest findings or crackles. Pneumothorax presents with sudden chest pain and dyspnea, with decreased breath sounds on the affected side.

So, the combination of swelling around the vocal cords with a barking cough is most characteristic of croup.