Acute Epiglottitis Flashcards
Is it common or rare?
Rare
Incidence has reduced with introduction of…
Haemophilius influenzae type B vaccination (HiB)
What is the usual age of presentation?
2 to 6 years old
In adults, what age do they present and is it more common in men or women?
40-50s
Affects more men
Adults who develop it are more likely to have…
Other underlying medical conditions that affect their immunity
Is it an emergency?
YES
What causes it?
Normally haemophilius influenza
Can get other bacterial causes
What symptoms occur?
Drooling Odonophagia Dysphagia Dysphonia - hot potato Pyrexia Dyspnoea Stridor
What signs are seen?
Tachycardia
Anterior neck tenderness over hyoid bone
Cervical lymphadenopathy
What is stridor a sign of?
Upper airway obstruction
Do children with epiglottis often have a cough?
No - rare to have a cough
May help distinguish it from laryngotracheobronchitis or croup
How is it managed?
Secure the airway
Child kept in calm environment with parents to avoid undue distress - may precipitate airway obstruction
If possible, child taken to theatre to be intubated by paed anaesthetist with ENT surgeon on standby to do a surgical airway if intubation not possible
If transfer to theatre not safe - intubate in A&E
IV antibiotics- patient will normally respond after a couple of days, after which they can be extubated
Should the patient be examined?
No - this may precipitate airway obstruction
What differentials are there?
Pharyngitis Laryngitis Inhaled foreign body Croup RPA
What can lateral x ray show?
Thumbprint sign
