Epiglottitis

what is it

life threatening medical emergency due to inflammation of epiglottis and supraglottic tissue, can result in rapid airway obstruction

epidemiology

most commonly seen in infants, Hib vaccine has caused decrease in incidence

causes

HiB primarily, but also strep pneumonia, group a strep and staph aureus as well as viral, fungal causes and thermal injury

presentation

severe sore throat and odynophagia, muffled ‘hot potato’ voice, stridor, resp distress, fever

if suspected

do NOT examine throat due to risk of acute airway obstruction, only do so if trained to intubate

investigations

lateral neck radiograph: thumb sign (only if patient is stable), flex fiberoptic laryngoscopy to visualise epiglottis (only if pt stable), blood cultures and throat swans

management

monitor pts in ICU, sometimes endotracheal intubation or emergent tracheostomy, broad spectrum abx (third gen cephalo), supportive care, monitoring and follow up, vaccination