A barking cough, characterized by a harsh, dry sound often compared to a barking seal, can be a concerning symptom. This distinctive sound arises from inflammation and narrowing of the upper airways, specifically around the voice box (larynx) and windpipe (trachea). While commonly associated with children, a barking cough can also affect adults, signaling various underlying health issues.
Common Infectious Causes
Infectious agents, both viral and bacterial, frequently lead to upper airway inflammation that can manifest as a barking cough.
Laryngitis
Laryngitis, an inflammation of the voice box, is a common culprit and is typically caused by viral infections. The swelling of the vocal cords in laryngitis can result in a hoarse or even lost voice, alongside a dry, barking cough.
Pertussis
Pertussis, commonly known as whooping cough, is a highly contagious bacterial infection caused by Bordetella pertussis. While its hallmark is a severe coughing fit followed by a high-pitched “whooping” sound as air is inhaled, adults may sometimes present with only a persistent hacking cough without the classic “whoop.” This bacterial infection can lead to prolonged coughing spells lasting several weeks or even months.
Croup
Croup, or laryngotracheobronchitis, is primarily a pediatric condition, but adults can rarely develop it. When it occurs in adults, croup is usually caused by a contagious virus, such as parainfluenza virus, leading to swelling around the vocal cords and windpipe. Adult cases of croup can present with a barking cough and may sometimes be more severe.
Non-Infectious Health Conditions
Beyond infections, several non-infectious conditions can also cause a barking cough in adults.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal Reflux Disease (GERD) is a condition where stomach acid flows back into the esophagus, potentially irritating the airways and vocal cords. This irritation can trigger a chronic cough, which may have a barking quality, even in the absence of typical heartburn symptoms. GERD-related coughs are often dry and tend to worsen at night or after meals.
Post-nasal Drip
Post-nasal drip, which occurs when excess mucus from the nose or sinuses drips down the back of the throat, can also induce a persistent cough. This mucus can irritate the throat, leading to a cough reflex that might sound barking, especially if accompanied by throat clearing or hoarseness. Allergies, colds, or sinus infections are common causes of increased mucus production leading to post-nasal drip.
Cough-Variant Asthma
Cough-variant asthma is a form of asthma where a chronic cough is the primary or only symptom, without the typical wheezing or shortness of breath. This cough can sometimes have a barking characteristic and may be triggered or worsened by exposure to cold air, certain chemicals, or allergens. Identifying cough-variant asthma requires specific diagnostic approaches.
Medications
Certain medications can also induce a cough as a side effect. Angiotensin-converting enzyme (ACE) inhibitors, commonly prescribed for high blood pressure and heart failure, are known to cause a chronic, dry, and often irritating cough in some individuals. This cough can sometimes sound barking. The cough can develop weeks or even months after starting the medication and usually resolves within a few weeks of discontinuing it.
When to Seek Medical Care
Immediate medical evaluation is necessary if the cough is accompanied by signs of severe respiratory distress, such as difficulty breathing, shortness of breath, or a bluish tint to the lips or skin, indicating a lack of oxygen. High fever, chest pain, or coughing up blood are also red flag symptoms that require urgent care.
A persistent barking cough lasting more than a few weeks, even without severe symptoms, should also prompt a visit to a healthcare professional. For instance, a cough that continues for over eight weeks is considered chronic and often requires medical investigation to determine its cause.
Epiglottitis
Epiglottitis, while rare, is a life-threatening condition characterized by inflammation and swelling of the epiglottis, a flap that covers the windpipe. Symptoms like severe sore throat, difficulty swallowing, drooling, a muffled voice, or a high-pitched breathing sound (stridor) necessitate immediate emergency medical attention. Prompt diagnosis and treatment are crucial to prevent airway blockage.