American Board of Family Medicine (ABFM) Practice Exam

What is the likely diagnosis for a 10-month-old child with sore throat and loss of voice, who is afebrile?

1. Pharyngitis

2. Laryngitis

3. Tonsillitis

4. Epiglottitis

The correct answer is: Laryngitis

In this scenario, the symptoms presented by the 10-month-old child—sore throat and loss of voice—are indicative of laryngitis. Laryngitis is an inflammation of the larynx (voice box), which can lead to hoarseness or loss of voice and is often triggered by viral infections, irritation, or overuse of the voice. The absence of fever further supports this diagnosis, as laryngitis often does not present with significant systemic symptoms, particularly in cases caused by viral infections. In contrast, pharyngitis would typically present with a more pronounced sore throat and might be accompanied by symptoms like fever or significant redness in the back of the throat. Tonsillitis, involving inflammation of the tonsils, commonly results in sore throat and may also feature fever, difficulty swallowing, and swollen tonsils. Epiglottitis, although less common in children due to vaccination, is a serious condition that usually presents with fever and can lead to difficulty breathing. The child’s afebrile state, combined with the symptom of loss of voice, strongly points to laryngitis as the most likely cause of the symptoms described.