30th April 2024

A 35-year-old man presents with a 24-hour history of rapidly worsening sore throat, difficulty swallowing, and a muffled voice.

A 35-year-old man presents with a 24-hour history of rapidly worsening sore throat, difficulty swallowing, and a muffled voice. He reports a high fever and appears distressed, preferring to sit upright. He denies any recent trauma or foreign body ingestion. On examination, he is drooling and has significant difficulty speaking. There are no visible lesions in the oral cavity, and the patient is anxious at the prospect of lying down.

Investigations:

Vital signs: Fever of 39.5°C, pulse 110 bpm, respiratory rate 24 breaths per minute.

Which test is most likely to help confirm the diagnosis?