QLexNursing

🔷 Exudate on pharynx → Acute Streptococcal Pharyngitis

Strep throat is caused by Group A beta-hemolytic streptococci, and a hallmark sign is tonsillar/pharyngeal exudate. This finding is not typical of RSV or epiglottitis, which involve airway swelling and obstruction rather than pus formation.

🔷 Fever → Epiglottitis, RSV, Strep

Fever is a nonspecific but common symptom across all three conditions:

Epiglottitis: Presents with sudden high fever due to acute bacterial infection .RSV: Often shows low-to-moderate fever with viral illness.

Strep throat: Usually includes moderate fever along with throat pain.

🔷 Tachypnea → Epiglottitis, RSV

Both epiglottitis and RSV impair the airway and lead to increased work of breathing.

Epiglottitis: The swollen epiglottis causes upper airway obstruction → rapid, shallow breathing.

RSV: Causes lower airway inflammation and mucus plugging, leading to rapid respiratory rate. Tachypnea is not expected in uncomplicated strep throat, since it mainly affects the throat, not the lungs.

🔷 Hypoxia → Epiglottitis, RSV

Epiglottitis: The narrowed airway prevents oxygen from entering, leading to oxygen desaturation.

RSV: Causes widespread bronchiolar obstruction from mucus and inflammation → impaired gas exchange. Hypoxia is not a feature of strep throat, which does not involve airway compromise.

🔷 Drooling → Epiglottitis

Drooling is a classic red flag for epiglottitis. The swollen epiglottis prevents swallowing, so the child cannot handle secretions. This is absent in RSV and strep throat, where swallowing is not obstructed.

🔷 Wheezing upon auscultation → RSV

Wheezing is caused by narrowed bronchioles and mucus plugging, which is characteristic of RSV bronchiolitis. Epiglottitis causes stridor (upper airway sound), not wheezing, and strep throat involves the pharynx only, so no wheezing is expected.