Case Files 3 - Peds: I'm Hot and Drooling Over You

Well, this is a case file from some site (will be revealed with the answers). Maybe you would want to try to test your Peds ability if you've gone through the posting. Link to answer page is located at the bottom of the post.

An 18-month-old girl presents was presented with 2 days of fever and irritability. On the day of arrival to the A&E, her mother reported that the child has developed new onset of drooling and decreased oral intake. Her past medical history is unremarkable. On physical examination, she is febrile, ill appearing, and has neck stiffness.
The following soft tissue lateral of the neck X-ray is obtained.

  1. What is the next most appropriate management strategy at this time?
    a. Discharge to home with supportive care
    b. Discharge to home with oral antibiotics
    c. Admit for intravenous antibiotics and surgical consultation
    d. Emergent intubation
    e. Cricothyroidotomy

  2. What is your diagnosis?

  3. What do you expect to see during your physical examination?

  4. Give at least 3 differentials, that would make use of radiographic evaluation to differentiate between them.

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