Croup Differential Diagnoses

Updated: Oct 09, 2019
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Diagnostic Considerations

Although croup is considered the most common cause of stridor and respiratory distress in the pediatric population, diagnostic differentials should be considered, dependent on clinical history and presenting symptoms, and include the following:

  • Spasmodic croup (recurrent croup, afebrile)

  • Retropharyngeal abscess

  • Subglottic stenosis

  • Angioedema

  • Allergic reaction

  • Tracheomalacia

  • Laryngeal web

  • Laryngeal papillomatosis

  • Laryngeal hemangioma

  • Subglottic hemangioma

  • Vocal cord paralysis

  • Uvulitis

  • Innominate artery compression

  • Right aortic arch vascular ring

  • Double aortic arch

  • Aberrant subclavian artery

  • Pulmonary artery sling

  • Gastroesophageal reflux (diagnostic consideration for recurrent croup)

  • Rarer etiologies in the pediatric population:  

    • Laryngeal tuberculosis, neoplasm (compressing trachea), sarcoidosis, Wegener granulomatosis

Differential Diagnoses