A 4-year-old child is brought into the emergency room (ER) by her parents, who state that an abrupt high fever developed along with a severe sore throat, dysphagia with drooling, and cough. In the ER, the girl exhibits stridor, muffled voice without hoarseness, air hunger, and cyanosis. She also has suprasternal, substernal, and intercostal retractions, with nasal flaring, bradypnea, and dyspnea. The child is sitting upright with her chin thrust forward and her neck hyperextended in a tripod position. What condition is she likely exhibiting?

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Onset of bacterial epiglottitis is usually abrupt and associated with high fever; severe sore throat; dysphagia with drooling; cough, progressing rapidly over a few hours to stridor; muffled (hot potato) voice without hoarseness; air hunger; and cyanosis. Suprasternal, substernal, and intercostal retractions, along with nasal flaring, bradypnea, and dyspnea, are frequently displayed. The child assumes a characteristic position of sitting upright with the chin thrust forward and with the neck hyperextended (sniffing position) in a tripod position. The streptococcal variant of epiglottitis may be associated with a longer prodrome lasting more than 24 hours.

A 4-Year-Old Child Is Brought into the Emergency Room (ER)