1. Know the Possible Differential Diagnoses
Any parent can tell you that kids and respiratory illnesses go together like peanut butter and jelly. But whether an illness is a simple cold or something more serious is sometimes difficult even for trained medical professionals to determine. Croup is just such an illness. Marked by a distinctive cough frequently likened to a barking seal, this sometimes scary upper-respiratory illness can often be soothed simply by sitting with the child in a steamy bathroom or letting him breath cool night air. But parents should be aware that other, sometimes more serious, respiratory illnesses are misdiagnosed as croup. Some of the more common differential diagnoses--illnesses with symptoms similar to those of croup--include the good old common cold, acute bronchitis, epiglottis and whooping cough. Whooping cough is the most common illness for which croup is misdiagnosed. Aside from stuffiness or runny nose, the main distinguishing symptoms of whooping cough are a low fever and other cold symptoms such as sneezing and watery eyes. Whooping cough, formally known as pertussis, is on the rise thanks to the fact that the vaccine, once thought to confer lifetime immunity, is now known to wear off after about 10 years.
2. Monitor the Symptoms
Aside from the barking cough, symptoms of croup will likely include a high fever, restlessness, sore throat, difficult or noisy breathing, a hoarse voice, difficulty swallowing and a high-pitched whistle when breathing that's known as stridor. Croup, however, does not typically involve congestion. Whooping cough, colds and other respiratory illnesses, on the other hand, typically do.
3. Question the Diagnosis
If a doctor diagnoses your child with croup and you don't buy it for whatever reason, question the diagnosis. You are the steward of your child's well-being. No matter how uncomfortable it may make you feel, as an informed health care consumer and a responsible parent you need to express your concerns to your doctor and ask him if he has considered other differential diagnoses. If you are specifically concerned that your child may have whooping cough--which, by the way, is a reportable disease by federal public health standards--ask that your child be tested and be treated prophylactically with antibiotics, since the test results can take days to return. Whooping cough can be fatal to infants. If the child in question is an infant or there is an infant sibling in the home, it is essential that pertussis be treated quickly and aggressively.
