A 20 month old male presented to the emergency department with a chief complaint of cough. Two days ago he developed rhinorrhea, fever, a hoarse cry and a progressively worsening, harsh, "barky," cough. Today he developed a "whistling" sound when he breathes, so his parents brought him to the emergency department. His past medical history is unremarkable. His 6 year old brother also has cold symptoms. Exam: VS T 37.5, P 140, R 36, BP 90/64, oxygen saturation 96% in room air. He is alert, with good eye contact, in mild respiratory distress.
He has a dry barking cough and a hoarse cry. He has some clear mucus rhinorrhea but no nasal flaring. His pharynx is slightly injected, but there is no enlargement or asymmetry. His heart is regular without murmurs. His lung exam shows good aeration and slight inspiratory stridor at rest. He has very slight subcostal retractions. No…
