Which symptom helps distinguish epiglottitis from viral croup?

• A. Drooling
• B. Wheezing
• C. Sputum production
• D. Fever

Answer: (A)

Drooling reflects an inability to swallow secretions due to swelling of the epiglottis, which is characteristic of epiglottitis. In epiglottitis the swelling blocks the airway and swallowing becomes painful, so saliva pools and the child drools. Viral croup, on the other hand, involves subglottic swelling and presents with a barky cough and hoarseness; swallowing is less affected, so drooling is not prominent. Sputum production and wheezing aren’t reliable differentiators, and fever can occur in both conditions, so the presence of drooling is the best clue that points toward epiglottitis.