New Summary: Nerve Stimulation in Peripheral Nerve Blocks

Question of the Day

You are evaluating a 4-year-old boy for an urgent endoscopy. He was previously healthy and active but complained of a severe sore throat earlier today. His family elected to avoid vaccines for fear of autism. On exam, he is febrile and is sitting upright with his hands and on his knees with his neck extended. He is tachypneic and has excess salivation from his mouth. His voice is muffled and you note inspiratory stridor. Which of the following is the MOST likely explanation for his respiratory distress?

Bacterial epiglottitis

Foreign body

Peritonsillar abscess

Viral croup

View Explanation

Question of the Day

You are evaluating a 4-year-old boy for an urgent endoscopy. He was previously healthy and active but complained of a severe sore throat earlier today. His family elected to avoid vaccines for fear of autism. On exam, he is febrile and is sitting upright with his hands and on his knees with his neck extended. He is tachypneic and has excess salivation from his mouth. His voice is muffled and you note inspiratory stridor. Which of the following is the MOST likely explanation for his respiratory distress?

Your Answer

Correct Answer

Explanation

Epiglottitis is an uncommon bacterial infection of the epiglottis. It is usually rapid onset and presents with high fever, leukocytosis, and significant respiratory distress. Patients may be sitting upright, salivating, with their head extended. Haemophilus influenzae used to be a common cause of epiglottis but this has diminished significantly with the Haemophilus influenzae type B vaccine.

References:

Epiglottitis and Croup