A 5-year-old girl presented to the emergency department with a history of shortness of breath and coughing. Although she had been coughing for several weeks, there was an abrupt change in character and the cough became more "croupy" on the night of her presentation to the hospital. The patient complained of a "scratchy" sensation in her throat. No fever was reported.
On physical examination, the patient's vital signs were as follows: temperature, 37.2°C; pulse, 150 beats per minute; respiratory rate, 26 per minute; and blood pressure, 120/65 mm Hg. She was a well-developed child who was alert and cooperative. She was not in respiratory distress, but had a dry, croupy cough and mild inspiratory and expiratory stridor, and constantly attempted to clear her throat. The remainder of the examination findings were normal. A pulse oximeter reading showed 95% to 100% oxygen saturation in room air. Chest radiographic findings were normal.