Key points for diagnosis
(1) The pharyngolarynx is painful, and the pain is generally severer. Swallowing food is more painful than swallowing nothing. Accordingly, most patients have no appetite. In severe cases, the patient even has difficulty in swallowing the saliva in the mouth.

(2)There exists the sensation of obstruction in the pharyngolarynx. The patient feels that the pharyngolarynx is obstructed by the foreign object. In mild cases, the patient feels tense in the larynx; in severe cases, the epiglottis is severely swollen and the glottis becomes small; if the throat is obstructed by sticky sputum, the patient may have inspiratory dyspnea, even suffocation in severe cases. The patient seldom has hoarseness because the site of swelling does not lie in the vocal fold.

(3)  At the beginning, the general symptoms include aversion to cold and fever with the temperature ranging from 38 to 39℃. A small number of patients may reach above 40℃. Generally, higher fever occurs in children and young people. The disease develops quickly. Besides dyspnea, the patient simultaneously has general symptoms of listlessness, hyposthenia, cold limbs, pale complexion, rapid and thready pulse, drop of blood pressure, even coma and shock in severe cases.

(4) Local examination shows pharyngeal congestion, epiglottic swelling and pachynsis or congestion. Severe swelling exists in the surface of epiglottis opposite the tongue. The epiglottis may be ball-shaped in severe cases. If abscess forms, the examiner may see yellow-white purulent spots on the epiglottic surface against the tongue. The patient can not raise his epiglottis. Accordingly, the examiner can not see the vocal fold with an indirect laryngoscope, Congestion and swelling may also exist in the mucosae of the aryepiglottic fold and the arytenoid cartilage.

(5) Hemogram may indicate increased total white blood cell, or increased neutral granulocytes.

(6)The laryngeal lateral X-ray film may show epiglottic enlargement, shrinked shadow of the laryngopharyngeal cavity with distinct borders. These are of a certain value for the diagnosis of acute epiglottiditis in children.