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A 2-year-old girl presented to the department with a history of fever (>40°C) and increasing dysphagia although she was still able to drink. Forty-eight hours beforehand, she had developed nocturnal grunting and torticollis but there was no history of stridor. There was no other relevant previous medical history nor recent foreign travel and she had been fully vaccinated.
Despite appearing quiet and unwell, her systemic examination (including neurology) was unremarkable, her pharynx appeared normal and there was no evidence of an infectious ‘source’ other than palpable non-tender cervical lymph nodes and torticollis. Routine observations were within normal limits apart from documented fever and an associated mild tachycardia.
What life-threatening differentials should be considered in a child presenting with a fever and sore throat? …
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.