Epiglottitis

Question 1

Definition of epiglottitis

Answer 1

• Inflammation and swelling of the epiglottis caused by infection
• Usually caused by haemophilus influenza type B
• Can obscure airway within hours of symptoms and is a life threatening emergency
• Now rare due to routine vaccination

Question 2

Presentation of epiglottitis

Answer 2

• Sore throat
• Stridor
• Drooling
• Tripod position
• High fever
• Difficulty or painful swallowing
• Scared of quiet child
• Septic and unwell appearance

Question 3

Investigation of epiglottitis

Answer 3

• If acutely unwell and epiglottitis suspected no investigation required
• Lateral X-ray of the neck shows thumbprint sign (soft tissue shadow that looks like a thumb pressed on the trachea)

Question 4

Management of epiglottitis

Answer 4

• Do not distress patient as can worsen stridor
• Alert senior paediatrician and anaesthetics
• IV antibiotics (i.e. ceftriaxone)
• Steroids (i.e. dexamethasone)