A 4-year-old boy is brought to the emergency department with fever and neck pain

A 4-year-old boy is brought to the emergency department with fever and neck pain. He has had rhinorrhea, nasal congestion, and a sore throat

for the past week. Two days ago, he developed fever and worsening neck pain. Today, the patient has refused to eat or drink. He has no chronic

medical conditions and immunizations are current. Temperature is 39.7 C (103.5 F), pulse is 120/min, and respirations are 24/min. On

examination, the patient appears tired and uncomfortable. Palpation of the neck reveals bilateral anterior cervical lymphadenopathy. The patient

refuses to move his neck; passive extension is painful. His voice is muffled. Mouth opening is limited by pain, and the tonsils appear

erythematous and symmetrically enlarged with gray exudates. The uvula is midline. Chest auscultation reveals good bilateral air entry without

strider or rhonchi. Lateral neck radiograph shows widened prevertebral space but no other abnormalities. Which of the following is the most

likely diagnosis in this patient?

  • QA Diphtheria
  • 0 B. Epiglottitis
  • 0 C . Meningitis
  • 0 D. Peritonsillar abscess
  • 0 E. Retropharyngeal abscess
  • 0 F Tracheitis

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