Inflammatory Lesions

87, 231]. The most consistently found presenting symptom is severe pain on swallowing. In children, breathing difficulties are often the predominant symptom. Other symptoms and signs are hoarseness, drooling, fever, tachycardia and toxic appearance [75, 87]. Reddish and evidently oedematous supraglottic area, including tongue and pharyngeal structures, is observed. Oede-matous swelling rarely spreads to the glottic region.

Microscopic examination shows diffuse exudative inflammation with fibrin, neutrophils and erythrocytes involving supraglottic structures. An early complaint of dyspnoea may safely discriminate between patients requiring invasive airway management with intubation and conservative treatment with close observation [150].

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