Acute epiglottitis: The Daily PANCE Blueprint

The answer is C. Epiglottitis

The patient’s presentation of severe sore throat, difficulty swallowing (dysphagia), drooling, and the characteristic posture of sitting upright and leaning forward are highly suggestive of epiglottitis. This condition, which is inflammation of the epiglottis and adjacent supraglottic structures, can progress to life-threatening airway obstruction if not treated promptly. In adults, epiglottitis is often caused by oro- and nasopharyngeal bacterial pathogens other than Haemophilus influenzae type b (Hib), which was more common in children before the widespread use of Hib vaccines.

Incorrect Answer Explanations:

• A. Acute laryngotracheobronchitis (croup) typically presents in children with a characteristic barking cough and stridor. The patient’s age and symptoms are not typical for croup.
• B. Bacterial tracheitis is a severe, bacterial infection of the trachea, usually seen in children. It presents with high fever, cough, and stridor, which are not the predominant features in this patient’s presentation.
• D. Peritonsillar abscess typically presents with severe sore throat, unilateral swelling, deviation of the uvula, and trismus (difficulty opening the mouth). These features are not prominent in this patient’s case.
• E. Retropharyngeal abscess usually presents with neck pain, stiffness, and dysphagia in younger children. The patient’s age and the absence of neck stiffness or pain make this diagnosis less likely.