Which feature best distinguishes croup from epiglottitis?

• A. Drooling and dysphagia.
• B. Frog-like croaking.
• C. Barky cough that worsens at night.
• D. Absence of cough.

Answer: (C)

Croup is best distinguished from epiglottitis by a barking cough that worsens at night. This classic cough comes from subglottic edema and inflamed larynx, with symptoms often intensifying during the night as airway reactivity increases. Epiglottitis, in contrast, typically presents with drooling, difficulty swallowing, a muffled voice, and high fever, with little or no cough because the focus is on epiglottic swelling and airway protection rather than a laryngeal cough reflex. So the nighttime barking cough is the feature that most clearly separates croup from epiglottitis. The other signs—drooling/dysphagia, absence of cough, or less typical descriptions like frog-like croaking—are less reliable indicators for distinguishing between the two.