USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 46-year-old man comes to the emergency department because of a sore throat. He reports difficulty swallowing solid foods, a "hoarse" voice, and fevers up to 40.5°C (105°F) since yesterday. He denies any neck swelling or stiffness. He has no significant past medical history and rarely sees a doctor. He says he immigrated to the United States from the Dominican Republic as a child. Examination of the oropharynx is normal. A lateral radio-graph of the patient's neck is ordered and is shown below.
Content Reviewers:Rishi Desai, MD, MPH
Contributors:Tanner Marshall, MS
Like the rest of the respiratory tract, the walls of the larynx are made up of mucosal epithelium.
The lateral borders of the epiglottis connect to the aryepiglottic folds, which contain ligamentous and muscular fibers. This allows the epiglottis to act like a lid on a box and serve as the guardian of the airways.
Most commonly, epiglottitis is caused by Haemophilus influenzae, a gram negative rod bacterium, but in settings where Haemophilus influenzae type b vaccine is used commonly, other bacterial like Group A Streptococcus can also cause the infection.
These bacteria are spread person-to-person by direct contact or through respiratory droplets that are created when people cough or sneeze.
The cytokines cause blood vessels to become more permeable to fluid which results in local inflammation or swelling.