Final answer:
Epiglottitis is the likely diagnosis based on the symptoms described, and the most common bug causing it is Haemophilus influenzae type b. An x-ray of the neck can help confirm the diagnosis by showing a swollen epiglottis. Urgent airway management and antibiotic treatment are essential.
Step-by-step explanation:
The symptoms of the 2-year-old, including fever, drooling, intercostal retractions, and tripod position, along with the buzzword of intercostal retractions, suggest epiglottitis. The most common bug causing epiglottitis is Haemophilus influenzae type b. However, since the child is vaccinated, it is less likely to be caused by this bug. Instead, it could be caused by respiratory syncytial virus (RSV), Streptococcus pneumoniae, or Staphylococcus aureus.
The next best step in diagnosing epiglottitis is to perform a x-ray of the neck, which may show a swollen epiglottis, also known as the 'thumb sign.'
The treatment for epiglottitis is urgent airway management, as this condition can rapidly progress to airway obstruction. The child may need to be intubated or have a tracheostomy performed. Antibiotics such as ceftriaxone or cefotaxime should also be administered to cover for potential bacterial causes.