Supraglottic swelling is most consistent with which condition?

• A. Croup
• B. Foreign body aspiration
• C. Respiratory syncytial virus
• D. Epiglottitis

Answer: (D)

Supraglottic swelling points to inflammation above the glottis, most classically epiglottitis. In this condition the epiglottis and surrounding supraglottic tissues swell, causing rapid-onset high fever, severe sore throat with pain on swallowing, drooling, a muffled or "hot potato" voice, and a preference to sit upright or lean forward to help keep the airway open. Because the swelling is above the vocal cords, airway obstruction can progress quickly, making urgent, controlled airway management essential.

Croup, by contrast, mainly involves the larynx and subglottic area and presents with stridor and a barking cough, not the drooling or muffled voice typical of epiglottitis. Foreign body aspiration produces sudden onset choking or coughing with possible unilateral wheeze, rather than prominent supraglottic swelling. RSV infection causes bronchiolitis with lower-airway symptoms like tachypnea, diffuse wheeze, and crackles, not a primary supraglottic swelling pattern.