Epiglottitis

Question 1

Clinical features of epiglottitis

Answer 1

• Intense swelling of epiglottis and surrouning tissues
• • septicaemia
• 1-6 years can affect all age groups
• high fever
• ill, toxic-looking child
• intensely painful throat
  
  • child unable to swallow or speak- saliva drooling
• soft inspiratory stridor
• rapidly increasing respiratory difficulty over hours
• sitting, immobile, upright, open mouth

Question 2

Epiglottitis vs…

Answer 2

• Croup
  
  • ​Onset: days
  • Preceding coryza: yes
  • Cough: severe, barking
  • Able to drink: yes
  • Drooling saliva: no
  • Appearence: unwell
  • Fever: <38.5 C
  • Stridor: harsh, ripping
  • Voice/ cry: hoarse
• Epiglottitis
  
  • ​Onset: hours
  • Preceding coryza: no
  • Cough: Absent or slight
  • Able to drink: no
  • Drooling saliva: yes
  • Appearence: tonix, very ill
  • Fever: >38.5 C
  • Stridor: soft, whispering
  • Voice/ cry: muffled, reluctant to speak
• Other differentials
  
  • ​bacterial tracheitis- high fever, toxic, loud harsh stridor
  • inhalation of smoke/ hot air in fire
  • trauma
  • retropharyngeal abscess
  • laryngeal foreign body
  • allergic laryngeal angioedema
  • hypocalcaemia (vit. D deficiency)
  • infectious mononucleosis –> LN swelling
  • measles
  • diptheria

Question 3

Causes of epiglottitis

Answer 3

• Haemophilus influenzae type B