QuestionSBA
QuestionChoice
Acute epiglottitis is a life-threatening cause of respiratory distress in children due to the risk of airway obstruction. It is typically caused by Haemophilus influenzae type b. Conjugate vaccines to Hib mean the disease is now much less common. However, children who are not up-to-date with their vaccinations, or in households who refuse vaccination, are at greater risk. Clinical features include rapid onset, high temperature, generally unwell, stridor, drooling of saliva and presenting in a 'tripod' position: leaning forward and extending their neck in a seated position to maximise airway opening.
10005401
a
Acute Epiglottitis
QuestionChoice
Subglottic stenosis can be defined as the narrowing of the upper airway, which lies between the vocal folds and the lower border of the cricoid cartilage. It can be congenital or acquired. In congenital subglottic stenosis, symptoms usually appear shortly after birth. The main symptoms are biphasic stridor, dyspnoea, air hunger, and suprasternal, intercostal, and diaphragmatic retractions. Abnormal cry, aphonia, or hoarseness occur when the vocal cords are affected. In acquired subglottic stenosis, there is a history of laryngeal insult often by trauma, and symptoms usually occur three to four weeks after the insult.
10005404
d
Subglottic stenosis
QuestionChoice
This is a condition which can present at any age. It is an acute swelling of the upper airway that may cause dyspnoea and stridor. Fever is uncommon though. Swelling of the face, tongue, or pharynx are often also present.
10005405
e
Angioneurotic oedema
QuestionChoice
This may present with sudden onset dyspnoea and stridor but there is usually a clear history of foreign body inhalation or ingestion and no prodrome or symptoms of viral illness as well as no fever (unless secondary infection).
10005403
c
Foreign body obstruction
QuestionChoice
Croup should be suspected in a child with a sudden onset of a seal-like barking cough. Hoarse voice is also common. Symptoms are typically worse at night and increase with agitation.
10005402
b
Croup (Laryngotracheobronchitis)
Concept
Chapter
2693
4399
Acute Epiglottitis
Topic
153
Paediatrics
13627
An unvaccinated two-year-old toddler presents to the paediatric assessment unit with his mother following a referral from his GP. He is in obvious distress and presents with a fever of 40.5 degrees, as well as soft stridor. His mother says that, over that last few hours, he has been unusually drooling a lot and resting in a tripod position.

Which of the following is the most likely diagnosis?
a