Epiglottitis

Question 1

What is Epiglottitis?

Answer 1

Epiglottitis is the inflammation and swelling of the epiglottis caused by infection. The epiglottitis can swell to the point of completely obscuring the airway within hours of symptoms developing. Epiglottitis is a life-threatening emergency.

Question 2

What bacteria causes Epiglottitis?

Answer 2

• Haemophilus Influenza Type B

Question 3

What is the typical presentation of Epiglottitis?

Answer 3

• unvaccinated child
• Sore throat / Stridor
• Drooling
• Tripod Position
• High Fever
• Difficulty/ Painful Swallowing
• Muffled Voice
• Scared and Quiet
• Septic Appearance

Question 4

What Investigations would you do for a patient with suspected Epiglottitis?

Answer 4

• Lateral Xray of the neck - shows thumb sign/ thumbprint sign (soft tissue shadow that looks like a thumb pressed into the trachea - caused by oedematous/ swollen epiglottis)
• Neck Xrays - excluding foreign body

Question 5

What Managment would you do for Epiglottitis?

Answer 5

• DO NOT DISTRESS THE PATIENT (prompting closure of the airway)
• Alert the senior paediatrician and anaesthetist
• Make arrangements for Intubation and possible Tracheostomy - ensure there is space in ICU

Once airway is secure:
- IV ABX - Ceftriaxone
- Steroids - Dexamethasone

Question 6

What is a common complication of Epiglottitis?

Answer 6

• Epiglottic Abscess - collection of pus around the epiglottitis, which threatens the airway making it a life-threatening emergency