A cough can point many possible underlying conditions. One way to determine the culprit is to listen to how the cough sounds. Pertussis and croup are common cough sounds. However, they are each associated with a distinct illness. Knowing what your cough sounds like can be pretty helpful. It can tell you whether it’s your run-of-the-mill condition or if it’s time to consult your doctor. So what are the critical differences of pertussis vs. croup?

What is pertussis?

Pertussis is also known as “whooping” cough. It is caused by bacteria called Bordetella pertussis. While commonly diagnosed in children, adolescents and adults can also get infected. When you have a whooping cough, this is usually accompanied by a cough that comes and goes and coughing up phlegm or vomiting. 

pertussis vs. croup | Photo by Gustavo Fring from Pexels | https://www.pexels.com/photo/a-man-in-black-jacket-wearing-a-face-mask-3983402/?utm_content=attributionCopyText&utm_medium=referral&utm_source=pexels

This disease usually spreads through droplets, which you produce whenever you cough. B. pertussis attaches itself to and damages the lining of your throat. It sticks to cilia in your airway and impedes their ability to clear substances away from your lungs. With all those substances pooling in your throat, you then develop the characteristic “whooping cough.” Worth noting too is that you are usually still infectious until after you have completed five days of antibiotic treatment. 

Treatment usually involves antibiotics given within the first three weeks from the time you experience symptoms. It is at this time that the antibiotic medication is most effective against the offending bacteria. After three weeks, however, antibiotics are not usually recommended. The only exception to this are pregnant women near term, who are recommended to receive antibiotics up to six weeks after their cough symptoms. Past six weeks, patients with asthma, chronic obstructive pulmonary disease, or immunocompromised state would also benefit from antibiotics. Generally, most people recover even without antibiotics within six weeks. 

How about croup?

In contrast to pertussis, croup has a characteristic “barking cough.” This cough is especially apparent in infants and children. In adults, there is usually hoarseness. You experience these symptoms due to inflammation of your voice box and airways. 

Here are some important definitions to remember when we talk about croup:

  • Laryngotracheitis (croup) – respiratory illness marked by inspiratory stridor, barking cough, and hoarseness
  • Viral croup – also called classic croup, is the typical croup syndrome for children six months to three years old, which involves fever, cough, and nasal congestion
  • Spasmodic croup – occurs within children six months to three years of age; the cough usually occurs at night, and the symptoms start and resolve abruptly

Viruses usually cause croup, but bacteria can too. The most common cause of acute croup is Parainfluenza virus type 1. This virus is common in the fall and winter months. Like B. pertussis, Parainfluenza viruses (PIV) can attach to your tissues and cause disease. However, they differ in that PIV sticks to cells in your nose and throat. From there, the disease severity depends on how far the virus can spread. Your symptoms will be milder if the condition is limited to your upper airways. If the infection spreads to your large airways and lungs, the disease may become more severe. 

Symptoms of Croup

Treatment of croup depends on its severity. You can manage a mild croup at home. You can use mist, antipyretic medication, and drink plenty of fluids. Sitting in a bathroom filled with hot steam can ease symptoms. Watch out for the following alarm signs:

  • Difficulty breathing
  • Turning pale or bluish
  • Severe coughing spells
  • Drooling or difficulty swallowing
  • Fatigue
  • Worsening symptoms
  • Fever >38.5C
  • Symptoms lasting longer than seven days
pertussis vs. croup symptoms | Photo by Kelly Sikkema on Unsplash | https://unsplash.com/s/photos/sick-kid?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText

For moderate to severe croup, this warrants an immediate trip to the hospital. Your doctor may administer steroids and nebulized epinephrine to mitigate symptoms. Supportive care is also necessary. This involves using humidified air or oxygen, antipyretics, and encouragement to increase fluid intake. If you respond well to the medication, your doctor can discharge you as early as three to four hours later. 

Pertussis vs. Croup

While pertussis and croup are both lung diseases, they differ in the cause, symptoms, and treatment. Regardless, you should immediately consult your doctor if you experience any of the alarm signs previously mentioned. Knowing all these can not only help you catch the disease early, but it can also protect those around you from getting infected.

Here is a simple table to remember pertussis vs. croup:

CauseB. pertussisParainfluenza virus
Cough soundWhooping, gasping soundBarking; harsh, grating sound
SymptomsLow-grade fever, mild cough, runny nose, struggled breathing, blue lips, vomiting and gaggingLow grade fever, swelling and inflammation of vocal cords, coughing, difficulty breathing, hoarseness
TreatmentAntibioticsSteroids, nebulized epinephrine, supportive care

Click here if you want to learn more about pertussis, croup, and the comparison between pertussis vs. croup.


Cornia, P. and Lipsky, B. (2021). Pertussis infection: Epidemiology, microbiology, and pathogenesis. Accessed on 24 Nov 2021 – weblink

Cornia, P. and Lipsky, B. (2021). Pertussis infection in adolescents and adults: Treatment and prevention. Accessed on 24 Nov 2021 from uptodate.com

Munoz, F. and Edwards, M. (2021). Parainfluenza viruses in children. Accessed on 24 Nov 2021 from uptodate.com

Whelan, C. (2020). The Difference Between Croup and Whooping Cough. Accessed on 24 Nov 2021 from healthline.com

Woods, C. (2021). Croup: Clinical features, evaluation, and diagnosis. Accessed on 24 Nov 2021 from uptodate.com

Woods, C. (2021). Management of croup. Accessed on 24 Nov 2021 from uptodate.com


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