A 5 year old is seen in the urgent care clinic with the following history and symptoms: sudden onset of severe sore throat after going to bed, drooling and difficulty swallowing, axillary temp of 102.2f, clear breath sounds, and absence of cough. The child appears anxious and is flushed.
1. Based on these sypmtoms and history, the nurse anticipates a diagnosis of .
a. GABHS (group A beta-hemolytic treptococcus pharyngitis)
b. actue tracheitis
c. acute epiglottitis
d. acute laryngotracheobronchitis
C. Acute Epiglottitis
Before explaining why C is the correct answer, let's look at why the others are not correct:A. GABHS is a bacterial infection that is a type of streptococcus (aka Strep). It is also the most common cause of Tonsillitis! Symptoms of GABHS typically include: Sore Throat, fever, swollen lymph nodes, and tonsillar exudates. It sounds very like what we're looking for, but notice drooling isn't a symptom found with this one!B. Acute Tracheitis is inflammation of the trachea often resulting from a bacterial infection. Symptoms of this condition are more breathing-related such as severe dry cough, wheezing, and even shortness of breath and cyanosis. Not what we're looking at.D. Acute Laryngotracheobronchitis is a common disease found in young children that is more commonly known as Croup. This disease is most often characterized by a "barking cough." Other symptoms include fever, stridor and hoarseness.
Now, WHY is C the correct answer?:
Acute Epiglottitis is, like croup, commonly found in younger children and is defined as inflammation of the epiglottis (the flap that covers the trachea when swallowing). It is often characterized by fever, sore throat, difficulty swallowing, and (more specifically) drooling! The drooling coupled with the clear bilateral breath sounds and absence of a cough help to diagnose this illness.
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