Case 3

A father presents with his 3-year-old daughter. The father tells you that over the last 12 hours she has been quiet, felt 'hot to touch', complained of a sore throat and has been eating less than normal.

Examination reveals a temperature of 37.8^o Celsius, stridor, respiratory rate of 30 breaths per minute, increased use of the accessory muscles, pulse of 120 beats per minute, CRT <2 seconds and the child is speaking to you.

Name 5 differential diagnoses.

You prescribe some paracetamol and are called to the resuscitation room to see another patient. You come back one hour later to find the child has a temperature of 40^o Celsius, is sitting drooling, has soft stridor and is using her accessory muscles of respiration.

What is the diagnosis and what is the most likely aetiology? Choose one diagnosis and one aetiology.

What are the next four things you are going to do and what is the definitive management?