A person developed sudden stridor, hoarseness of voice, tongue swelling, and edematous neck after eating a peanut. What is the likely diagnosis
**Core Concept**
Anaphylaxis is a severe, life-threatening allergic reaction that occurs within minutes of exposure to an allergen, leading to symptoms such as stridor, hoarseness of voice, tongue swelling, and edematous neck, among others. The pathophysiology involves the release of histamine and other mediators from mast cells, causing vasodilation, increased vascular permeability, and smooth muscle contraction.
**Why the Correct Answer is Right**
The symptoms described, including sudden stridor and hoarseness of voice, are indicative of laryngeal edema and airway obstruction. The presence of tongue swelling and edematous neck further supports the diagnosis of anaphylaxis. The trigger in this case is eating a peanut, which is a common allergen that can cause severe reactions in susceptible individuals. The body's immune response to the peanut leads to the release of histamine and other mediators, which cause the symptoms of anaphylaxis.
**Why Each Wrong Option is Incorrect**
**Option A:** Angioedema is a condition characterized by localized swelling of the skin and mucous membranes, but it typically does not cause stridor or hoarseness of voice. Angioedema can be caused by various factors, including hereditary and acquired angioedema, but anaphylaxis is a more likely diagnosis in this case.
**Option B:** Epiglottitis is an infection of the epiglottis that can cause stridor and airway obstruction, but it is typically accompanied by fever, sore throat, and difficulty swallowing. The sudden onset of symptoms and the trigger of eating a peanut make anaphylaxis a more likely diagnosis.
**Option C:** Laryngitis is an inflammation of the larynx that can cause hoarseness of voice, but it is typically not accompanied by stridor, tongue swelling, or edematous neck. Laryngitis is often caused by viral or bacterial infections, but anaphylaxis is a more severe and life-threatening condition.
**Option D:** Foreign body aspiration can cause stridor and airway obstruction, but it is typically not accompanied by tongue swelling or edematous neck. The trigger of eating a peanut and the sudden onset of symptoms make anaphylaxis a more likely diagnosis.
**Clinical Pearl / High-Yield Fact**
Anaphylaxis is a medical emergency that requires immediate treatment with epinephrine and other supportive measures to prevent airway obstruction and cardiac arrest. It is essential to identify the trigger allergen and provide appropriate medical attention to prevent recurrence and anaphylaxis-related mortality.
**Correct Answer:** C. Anaphylaxis