Question:medium
A child presents with stridor, barking cough and difficulty in breathing since 2 to 3 days. He has fever and elevated leukocyte count. All of the following statements about his condition are true, except:
A child presents with stridor, barking cough and difficulty in breathing since 2 to 3 days. He has fever and elevated leukocyte count. All of the following statements about his condition are true, except:
Show Hint
Barking cough and steeple sign mean viral croup. Steroids and adrenaline, not antibiotics, are the mainstay.
Updated On: Jun 24, 2026
- Subglottic stenosis and hypopharyngeal dilatation may be seen on X-rays
- Boys are more commonly affected than girls
- Symptoms are predominantly caused by involvement of the subglottis
- Antibiotics form the mainstay of treatment
Show Solution
The Correct Option is D
Solution and Explanation
The clinical story is a textbook one. A toddler develops a seal like barking cough, noisy breathing on inspiration and respiratory distress over two or three days, with low grade fever. This is croup, or acute laryngotracheobronchitis, a viral illness usually driven by parainfluenza.
Now check each statement. The obstruction in croup sits at the subglottis, which is the tightest segment of a child airway, so saying symptoms come mainly from subglottic involvement is true. On imaging this subglottic swelling produces the classic steeple sign, and the airway above can balloon out as the hypopharynx dilates, so the radiology statement is true too. Epidemiology shows the disease favours boys, so that statement holds as well.
The trap is the treatment. Since a virus is to blame, an antibiotic does nothing for the swelling. Real treatment is supportive: keep the child calm, give humidified oxygen, use nebulised adrenaline when distress is significant, and give a single dose of dexamethasone to shrink the oedema. Antibiotics enter only if a bacterial complication is proven. So the claim that antibiotics are the mainstay is the wrong statement.
\[\boxed{\text{Antibiotics form the mainstay of treatment}}\]
Now check each statement. The obstruction in croup sits at the subglottis, which is the tightest segment of a child airway, so saying symptoms come mainly from subglottic involvement is true. On imaging this subglottic swelling produces the classic steeple sign, and the airway above can balloon out as the hypopharynx dilates, so the radiology statement is true too. Epidemiology shows the disease favours boys, so that statement holds as well.
The trap is the treatment. Since a virus is to blame, an antibiotic does nothing for the swelling. Real treatment is supportive: keep the child calm, give humidified oxygen, use nebulised adrenaline when distress is significant, and give a single dose of dexamethasone to shrink the oedema. Antibiotics enter only if a bacterial complication is proven. So the claim that antibiotics are the mainstay is the wrong statement.
\[\boxed{\text{Antibiotics form the mainstay of treatment}}\]
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