Epiglottitis

Question 1

Define epiglottitis

Answer 1

Paediatric emergency

Rapidly progressive infection causing inflammation of the epiglottis and surrounding tissues that may lead to abrupt blockage of the upper airway and death

Question 2

Risk factors for epiglottitis

Answer 2

Missed immunisations

Born overseas with poor immunisation coverage

Question 3

Aetiology of epiglottitis

Answer 3

Haemophilus Influenza B

Rare now due to the Haemophilus influenza B (Hib) vaccination

Question 4

Clinical features of epiglottitis

Answer 4

Most common in children aged 1-6 years (similar age group to croup)

High fever, ill, toxic looking child (septicaemia)

Intensely painful throat preventing child from speaking or swallowing; saliva drools down the chin

Soft inspiratory stridor and rapidly increasing respiratory difficulty over hours

Child sits immobile, upright with open mouth to optimise airway

Cough minimal or absent

Question 5

Management of epiglottitis

Answer 5

Get senior help – paediatric registrar/consultant, ENT, anaesthetist, alert ITU

Securing the airway is the first priority - intubation may be necessary

Once the airway is secure, take cultures and examine the throat

Oxygen

Treat with IV antibiotics: cefuroxime