Last reviewed: 28 Oct 2023
Last updated: 20 Jan 2023
Summary
Definition
History and exam
Key diagnostic factors
- nonvaccination with Hib vaccine
- sore throat
- dysphagia
- difficulty in controlling secretions
- toxic appearance
- acute distress
- fever
- tripod position
- difficulty breathing
More key diagnostic factors
Other diagnostic factors
- decreased oral intake
- muffled voice
- stridor
- irritability
- drooling
Other diagnostic factors
Risk factors
- nonvaccination with Hib vaccine
- immunocompromise
- middle age
More risk factors
Diagnostic investigations
1st investigations to order
- laryngoscopy
- lateral neck radiograph
More 1st investigations to order
Investigations to consider
- complete blood count
- cultures of blood/supraglottis (epiglottis)
More investigations to consider
Treatment algorithm
ACUTE
initial presentation
ONGOING
once stable and extubated
Contributors
Authors
Rahul K. Shah, MD, FAAP

VP, Chief Quality and Safety Officer
Children's National Health System
Washington
DC
Disclosures
RKS declares that he has no competing interests. RKS is an author of references cited in this topic.
Peer reviewers
Scott Brietzke, MD
Walter Reed Army Medical Center
Department of Surgery - Otolaryngology Service
Washington
DC
Disclosures
SB declares that he has no competing interests.
Sanjay Parikh, MD
Associate Professor
Department of Otorhinolaryngology - Head and Neck Surgery
Albert Einstein College of Medicine
Bronx
NY
Disclosures
SP declares that he has no competing interests.
Kimsey Rodriguez, MD
Ochsner Health System
Department of Otolaryngology
New Orleans
LA
Disclosures
KR declares that he has no competing interests.
David Parry, MD
Catalina ENT
Tucson
AZ
Disclosures
DP declares that he has no competing interests.
Differentials
- Peritonsillar abscess
- Tonsillitis
- Foreign body aspiration
More DifferentialsGuidelines
- Clinical guidelines - diagnosis and treatment manual
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