What are the key clinical signs and symptoms that suggest a diagnosis of epiglottitis in adults and children?

Key clinical signs and symptoms suggesting epiglottitis in both adults and children include:

• Sudden onset of severe sore throat often disproportionate to oropharyngeal findings, indicating deep tissue inflammation NICE NG240 Fontanarosa et al. 1989.
• High fever commonly accompanies the presentation in both age groups NICE NG240 Sobol & Zapata 2008.
• Dysphagia and odynophagia (difficulty and pain on swallowing) are prominent features due to epiglottic swelling NICE NG240 Fontanarosa et al. 1989.
• Drooling is a key sign, especially in children, reflecting inability to swallow saliva secondary to painful throat and airway obstruction risk NICE NG240 Sobol & Zapata 2008.
• Stridor and respiratory distress may develop rapidly, indicating upper airway obstruction; this is a critical sign in both adults and children NICE NG240 Fontanarosa et al. 1989.
• Voice changes such as muffled or hoarse voice are common due to supraglottic inflammation NICE NG240 Sobol & Zapata 2008.
• Tripod or sniffing position is often adopted by children to ease breathing, and may also be seen in adults NICE NG240 Fontanarosa et al. 1989.
• Absence of cough helps differentiate epiglottitis from croup, which is more common in children NICE NG240 Sobol & Zapata 2008.

Overall, the clinical picture is of a rapidly progressive upper airway infection with severe throat pain, fever, difficulty swallowing, drooling, and signs of airway obstruction. Early recognition of these signs in both adults and children is essential to prevent airway compromise NICE NG240 Fontanarosa et al. 1989Sobol & Zapata 2008.