Rare condition, which can be a life-threatening infection if not detected early.
Potential threat to airway should always be considered.
Symptoms may be non-specific (e.g., fever, dysphagia), especially in children under 2 years old.
CT scan of neck is the definitive investigation.
Treatment includes use of intravenous antibiotics and surgical drainage.
History and exam
Key diagnostic factors
- presence of risk factors
- spiking fever
- neck pain or torticollis
- neck swelling/mass/lymphadenopathy
- oropharyngeal swelling
Other diagnostic factors
- decreased oral intake
- sleep apnoea
- tonsillar swelling
- increased respiration rate
- decreased oxygen saturations
- tracheal tug
- intercostal recession
- foreign body ingestion
- trauma to posterior pharyngeal wall
- dental caries/infection
- diabetes mellitus
- male sex
1st investigations to order
- erythrocyte sedimentation rate
- CT neck with contrast
- x-ray of neck
- ultrasonography of neck
- examination under anaesthetic (EUA)
no airway compromise
- Acute epiglottitis
- Management of sore throat and indications for tonsillectomy: a national clinical guideline
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