Epiglottitis

Question 1

Define epiglottitis

Answer 1

Rapidly progressive infection causes inflammation of epiglottis and adjacent tissues.
Inflammation can cause blockage and death.

Question 2

What is the relevant epidemiology of epiglottitis?

Answer 2

1-6yrs
Decreased where high prevalence of Hib vaccine
Rare in UK

Question 3

What is the most common pathogen causing Epiglottitis?

Answer 3

Haemophilus Influenza B
Less common - streptococcus pneumonia, fungal infections, varicella zoster virus

Question 4

What are the key signs and symptoms of epiglottitis?

Answer 4

High fever
Appear ill or toxic
Intense throat pain - prevent speaking or swallowing, drooling
Soft inspiratry stridor
Rapid increase in resp difficulty
Tendency to sit upright with an open mouth to optimse airway patency
Minimal or absent cough
Muffled or hoarse voice
Stridor

Question 5

What investigations should be done for epiglottitis?

Answer 5

Confirm by securing airway and using laryngoscopy to secure the airway.
Throat swab - causative organism
Lateral neck x-ray - thumb sign (due to thickening of aryepiglottic folds)
CT or MRI to check for abscess formation

Question 6

What does epiglottitis show in lateral XR?

Answer 6

Thumb printing sign

Question 7

What is the management for epiglottitis?

Answer 7

Do not examine or upset the child without senior support
Secure airway - potential endotracheal intubation
Culturing and examining throat once secure
Adminster IV antibiotics typically cefuroxime

Question 8

What are the potential complications for epiglottitis?

Answer 8

Abscess formation
Bacteraemia and sepsis
Meningitis
Pneumothorax
Airway obstruction and death