Barking Cough in Adults Croup Vector

Barking Cough in Adults: Causes and Treatment (2024)

by | Updated: May 31, 2024

A barking cough in adults is characterized by its distinctive harsh, loud sound akin to a seal’s bark that often signals an underlying issue within the respiratory system.

Although commonly associated with croup in children, adults can also develop this symptom due to a variety of causes ranging from acute viral infections to chronic conditions.

This article explores the causes, diagnosis, and treatment options for a barking cough in adults and how to distinguish this symptom to ensure proper management and care.

What is a Barking Cough in Adults?

A barking cough in adults is often characterized by a loud, harsh cough that sounds similar to a barking seal. This type of cough can be caused by conditions such as croup, which is rare in adults, or other respiratory issues like laryngitis or tracheitis. This symptom usually warrants medical evaluation.

Adult with a barking cough croup vector

Causes of a Barking Cough in Adults

A barking cough in adults can be caused by several conditions, including:

  • Croup: Although more common in children, croup can occasionally affect adults, leading to a distinctive barking cough.
  • Laryngitis: Inflammation of the voice box due to infections, irritants, or overuse can cause a harsh, barking cough.
  • Tracheitis: Bacterial infection of the trachea can result in a severe, barking cough.
  • Allergies: Allergic reactions can inflame the airways, resulting in a barking cough.
  • Gastroesophageal Reflux Disease (GERD): Acid reflux irritating the throat and larynx can lead to a chronic, dry, barking cough.
  • Asthma: Severe asthma attacks might produce a barking cough due to the constriction of airways.
  • Exposure to irritants: Smoke, chemical fumes, and other irritants can cause a temporary barking cough as the airways react to the irritant.

Note: In any case, a barking cough in adults is unusual and typically prompts a consultation with a healthcare provider to determine its cause.

What is Adult Croup?

Adult croup is a rare condition characterized by swelling and inflammation of the larynx (voice box), trachea (windpipe), and bronchi (large airways of the lungs). This inflammation leads to the typical symptoms of croup, which are more commonly observed in children. 

The causes of croup in adults can vary but often involve viral infections similar to those in children, such as parainfluenza viruses. However, other respiratory infections or conditions that cause airway inflammation can also lead to symptoms resembling croup.

Due to the rarity of the condition and the size and strength of adult airways compared to those of children, adult croup is generally less severe but still requires medical attention to manage symptoms and underlying causes effectively.

Symptoms

Symptoms of adult croup, though similar to those seen in children, can manifest with varying severity due to the larger size and greater resilience of adult airways.

Common symptoms include:

  • Barking Cough: The most distinctive symptom is a loud, harsh cough that resembles the bark of a seal.
  • Hoarseness: Inflammation of the voice box can lead to a change in voice, making it sound raspy or hoarse.
  • Stridor: A high-pitched, wheezing sound while breathing, particularly noticeable when taking deep breaths or during physical exertion.
  • Breathing Difficulties: Adults may experience tightness in the chest and difficulty breathing due to the swelling of the airway.
  • Sore Throat: The throat may feel sore or irritated, which can contribute to the cough and hoarseness.
  • Fever: Although less common than in children, adults with croup may also develop a fever.

Note: Given its rarity in adults and the potential for airway obstruction, anyone experiencing these symptoms should seek medical evaluation to ensure appropriate treatment and to rule out other causes of similar symptoms.

Diagnosis

Diagnosing croup in adults typically involves a combination of clinical evaluation and diagnostic tests to differentiate it from other respiratory conditions that might cause similar symptoms.

Here’s a typical diagnostic approach:

  • Medical History and Physical Examination: A healthcare provider will review the patient’s medical history, including any recent illnesses or exposures to respiratory infections. The physical exam will focus on the throat, lungs, and airways, with the provider listening for the characteristic stridor and barking cough.
  • Laryngoscopy: A laryngoscopy might be performed to visually examine the throat, larynx, and vocal cords. This can help to identify inflammation and any other abnormalities that could be causing symptoms.
  • Imaging: X-rays of the neck and chest can help to visualize the “steeple sign” — a narrowing of the upper trachea that is typical in croup. This sign might be less pronounced in adults.
  • Blood Tests: While not specifically diagnostic for croup, blood tests can help rule out bacterial infections or other conditions by assessing inflammatory markers.
  • Viral Tests: Swabs from the throat or nose can be tested for the viruses commonly associated with croup, such as parainfluenza.
  • Pulse Oximetry: This noninvasive test measures oxygen saturation in the blood, helping to determine if breathing difficulties are affecting oxygen levels.
  • Airway Evaluation: In severe cases, further assessment of the airway may be necessary to ensure that there is no impending blockage.

The diagnosis of adult croup is primarily based on the combination of clinical symptoms and findings from these tests, especially when typical features like a barking cough and stridor are present.

Proper diagnosis is crucial as the management of croup in adults can differ significantly from other respiratory conditions.

Treatment

Treating croup in adults focuses on relieving symptoms and addressing the underlying cause, usually a viral infection.

Treatment strategies may include:

  • Corticosteroids: Corticosteroids such as dexamethasone are commonly used to reduce airway inflammation and swelling quickly. This can help alleviate the barking cough and breathing difficulties associated with croup.
  • Breathing Treatments: Nebulized epinephrine may be used in severe cases to provide rapid relief from airway swelling. This is more commonly used in emergency situations. Inhalers or nebulizers containing bronchodilators might also be prescribed if there is significant wheezing or asthma-like symptoms.
  • Humidified Air: Breathing moist air can help soothe the inflamed airways. This can be achieved through a humidifier at home or even by taking a hot shower and breathing in the steam.
  • Adequate Hydration: Drinking plenty of fluids helps keep the throat moist and can reduce the discomfort caused by coughing.
  • Voice Rest: Minimizing talking can help reduce irritation of the vocal cords and larynx, which are often inflamed in cases of croup.
  • Over-the-Counter Pain Relievers: Medications such as acetaminophen (Tylenol) or ibuprofen (Advil) can help reduce fever and ease pain or discomfort.
  • Monitoring: Close monitoring at home is crucial for any signs of worsening, such as increased difficulty breathing, persistent high fever, or if the patient is unable to drink fluids adequately.
  • Hospitalization: In severe cases, especially if there are signs of respiratory distress or significant oxygen desaturation, hospitalization may be required for more intensive treatments and monitoring.

Note: Any adult experiencing symptoms of croup should consult with a healthcare provider for a proper diagnosis and appropriate treatment. Since adult croup is rare, it is also crucial to rule out other potential causes of similar symptoms.

How Serious is Croup in Adults?

Croup in adults is relatively rare, and while it can be concerning, it is usually less severe than in children due to the larger size and more robust nature of adult airways.

However, the seriousness of croup in adults can vary based on several factors:

  • Severity of Symptoms: Most cases in adults are mild and can be managed with medication and home care. However, severe symptoms such as significant breathing difficulty, stridor, or a rapid worsening of symptoms require immediate medical attention.
  • Underlying Health Conditions: Adults with pre-existing respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD), or those with weakened immune systems, may experience more severe symptoms and complications from croup.
  • Potential for Complications: While rare, complications such as bacterial superinfection of the upper airway, pneumonia, or, in extreme cases, respiratory failure can occur, especially if the croup is not adequately treated or if there are other underlying health issues.
  • Response to Treatment: Adults generally respond well to treatment with corticosteroids and other supportive measures. A good response can mitigate the severity of the condition, while a poor response may indicate a more serious issue or a need for more aggressive treatment.

Note: Due to these factors, it’s important for adults exhibiting symptoms of croup to seek medical advice promptly. Medical evaluation is essential to ensure the correct diagnosis and appropriate treatment plan, and to avoid potential complications.

FAQs About a Barking Cough in Adults

What Does a Barking Cough Indicate?

A barking cough typically indicates inflammation of the upper airways, such as occurs with croup, laryngitis, or tracheitis.

It is characterized by a loud, harsh cough that resembles the bark of a seal, signaling a possible viral infection or other irritation of the airways.

Can Adults Get Croup?

Yes, adults can get croup, although it is relatively rare. Adult croup is similar to pediatric croup but generally less severe due to the larger and more developed airways in adults.

Symptoms include a barking cough, hoarseness, and difficulty breathing, which need medical evaluation.

What are the Red Flags of Croup?

Red flags of croup that require immediate medical attention include severe difficulty breathing, stridor (a high-pitched, wheezing sound when breathing), signs of low oxygen levels (like bluish lips or fingers), and significant dehydration or inability to swallow fluids.

What is a Croup Cough in Adults?

A croup cough in adults is a loud, barking cough that sounds like a seal’s bark. It is caused by inflammation and swelling of the larynx and trachea.

While more common in children, when it occurs in adults, it can be a symptom of an underlying viral infection and often accompanies other symptoms like hoarseness and stridor.

How Long Does Croup Last?

Croup typically lasts for 5 to 7 days in both children and adults. The severity of symptoms usually peaks within the first two to three days before gradually improving.

Most cases can be managed at home, but prolonged symptoms may require medical attention.

Is Croup Contagious?

Yes, croup is contagious. It is usually caused by viral infections such as the parainfluenza virus, and it can be spread through respiratory droplets when an infected person coughs or sneezes.

Proper hygiene and avoiding close contact with those who are sick can help prevent the spread of the virus.

How to Get Rid of Barking Cough?

To alleviate a barking cough, you can use several methods:

  • Humidified air: Breathing in steam from a hot shower or a humidifier can soothe the inflamed airways.
  • Hydration: Drinking plenty of fluids helps keep the throat moist and reduces cough irritation.
  • Rest: Reducing voice use to rest the vocal cords and airways.
  • Medications: Corticosteroids or other prescribed medications can reduce inflammation and ease symptoms.

Note: If the cough persists or is severe, it is important to consult a healthcare provider.

Is a Barking Cough in Adults a Sign of COVID-19?

A barking cough in adults is not typically a sign of COVID-19. However, COVID-19 can cause a variety of respiratory symptoms, including coughing.

If a barking cough is accompanied by other symptoms of COVID-19, such as fever, shortness of breath, or loss of taste and smell, it is advisable to get tested for COVID-19 and consult a healthcare provider.

What is Whooping Cough in Adults?

Whooping cough, also known as pertussis, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. In adults, it presents as a severe hacking cough followed by a high-pitched “whoop” sound as the person breathes in.

The cough can last for several weeks and is often more severe at night. Vaccination is key in preventing whooping cough.

Can Allergies Cause a Barking Cough in Adults?

Yes, allergies can cause a barking cough in adults, particularly if the allergies lead to postnasal drip or irritation of the throat and airways.

Allergic reactions can inflame the airways, resulting in coughing that may have a barking quality, especially if there is significant throat irritation.

What Virus Causes a Barking Cough in Adults?

The most common viruses that can cause a barking cough in adults are the parainfluenza viruses, which are also the primary causes of croup.

Other viruses like respiratory syncytial virus (RSV) and influenza can also lead to a barking cough if there is significant inflammation of the upper airways.

When to See a Doctor for a Barking Cough?

You should see a doctor for a barking cough if:

  • The cough persists for more than a week or worsens.
  • It is accompanied by difficulty breathing, high fever, or signs of respiratory distress.
  • You experience dizziness, fainting, or blue lips, which could indicate low oxygen levels.
  • There is an inability to swallow or speak.

Note: These symptoms may indicate a more serious condition that requires medical attention.

Final Thoughts

A barking cough in adults is a significant symptom that should not be overlooked, as it may indicate underlying health issues that require prompt medical attention.

Adults experiencing a persistent or severe barking cough should consult healthcare professionals to ensure accurate diagnosis and appropriate treatment. This is essential for minimizing potential complications and enhancing overall respiratory health.

John Landry, BS, RRT

Written by:

John Landry, BS, RRT

John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.

References

  • Sizar O, Carr B. Croup. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
  • Patel JJ, Kitchin E, Pfeifer K. A Narrowing Diagnosis: A Rare Cause of Adult Croup and Literature Review. Case Rep Crit Care. 2017;2017:9870762. doi: 10.1155/2017/9870762. Epub 2017.

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