Which clinical manifestation is most commonly seen in viral croup?

• A. Drooling
• B. Wheezing
• C. Sputum production
• D. Inspiratory stridor

Answer: (D)

Viral croup causes inflammation and edema of the larynx and subglottic trachea, narrowing the upper airway. This narrowing is most evident during inspiration, producing the characteristic inspiratory stridor as air moves through the swollen, narrow passages. The barking cough and hoarseness accompany the airway irritation, but inspiratory stridor is the hallmark finding. Drooling would raise concern for more dangerous airway conditions like epiglottitis; sputum production is not typical since this is an upper airway viral process rather than a productive lower-airway infection; wheezing is more associated with lower airway diseases such as bronchiolitis or asthma.