Presentation
Stridor and cough.
Patient Data

Frontal view shows narrowing of the upper trachea (steeple sign).
Case Discussion
Given the presenting symptoms of cough and stridor, a chest radiograph was ordered and revealed narrowing of the subglottic airway. This finding is referred to as the steeple sign and is a characteristic radiographic finding of laryngotracheobronchitis (croup). Croup is an upper respiratory tract infection most often caused by parainfluenza or respiratory syncytial virus that typically occurs in children between the ages of 6 months to 3 years old.
The differential diagnosis of cough and stridor includes inhaled foreign body and epiglottitis.