Acute epiglottitis – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

January 5, 2021 5:20 am Published by

Acute epiglottitis is an acute inflammation of the supraglottic structures of the larynx, typically caused by H. influenza. It is a medical emergency and requires immediate referral to the ER.

Sn. & Sx.:

  • Rapid onset high fever, sore throat
  • Dysphagia
  • Acute distress
  • Toxic appearance (sitting, open mouth, drooling, tongue protruding)
  • Tripod position
  • Inspiratory stridor
  • Anorexia
  • Restlessness

dDx.:

  • Tonsillitis
  • Diphtheria
  • Laryngotracheobronchitis
  • Peritonsillar or retropharyngeal abscess
  • Foreign body aspiration

Sequelae:

  • Mediastinitis
  • Airway obstruction and hypoxia

Work up:

  • Physical examination is contraindicated
  • Lateral neck radiograph

Tx.:

  • Secure airway, intubation
  • Oxygen supplementation
  • IV access with hydration
  • IV antibiotics

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This post was written by Omar Rifai