Another sore throat

A 46 year old man presents with throat discomfort and pain upon swallowing since last night.

These symptoms rapidly worsened over time, such he now feels as if his throat is "closing up". The discomfort is worse on lying down.

He also feels weak and ill.

His medical history is unremarkable, while he has smoked a total of 20 pack years.

Select Relevant Investigations
Lateral X-ray neck (soft tissue view)


The lateral soft-tissue x-ray of the neck is positive for the "thumb sign".
Full Blood Count


WBC/DC: 10,000/ mm3
N: 82%
L: 18%
Hb: 13 g/dl
Plt: 225,000/mm3
Blood cultures


The culture reports will be available in 3 days. The gram stain is negative.
Fibreoptic laryngoscopy


A red, swollen epiglottis is visualized.

Select Relevant Management
Nil orally
Intubation stat
IV Antibiotics