URTI: Epiglottitis

Question 1

What is Epiglottitis?

Answer 1

Inflamm of Epiglottis + nearby supraglottic structures

Question 2

Why can Epiglottitis be life threatening?

Answer 2

Can cause airway obst

Question 3

What are the Risk Factors of Epiglottitis? (6 things)

Answer 3

1. Children (6-12 yrs)
2. Unimmunized status
3. Mucosal trauma (e.g burns / foreign body ingestion)
4. DM
5. Substance Abuse
6. BMI under 25

Question 4

What are the most common causes of Epiglottitis in Kids vs Adults?

Answer 4

• H influenzae (kids)
• Strep pneumoniae (adults)

(Both bacteria)

Question 5

What are the CF of Epiglottitis in kids? (4 things)

Answer 5

Hallmark CF = 4 D’s

1. Dysphagia
2. Dysphonia
3. Drooling
4. Distress

RAPID progress

Question 6

What are the CF of Epiglottitis? (11 things)

Answer 6

1. Severe sore throat (most common complaint in adults)
2. Dysphagia + odynophagia (difficulty + pain)
3. Dysphonia
4. Drooling
5. Distress
6. Fever
7. Stridor
8. Tachypnoea
9. Cyanosis (bc difficulty breathing –> resp distress)
10. Anxiety + refuses to lie down
11. Assumes tripod position (see pic) –> to maximise diameter of narrowed airway

Question 7

What is the difference in PROGRESSION of Epiglottitis in kids vs adults?

Answer 7

• Kids = RAPID progression
• Adults: slower progression

Question 8

If sus Epiglottitis, what should you do before further investigations?

Answer 8

Airway management bc med emergency

Question 9

What investigations should you do for sus Epiglottitis? (3 things)

Answer 9

1. Laryngoscopy (done under general) (GOLD)
2. Throat culture (positive)
3. XR
4. Bloods

Question 10

What will be seen / felt in a Laryngoscopy of Epiglottitis? (2 things)

Answer 10

1. Inflamm Epiglottis (+ supraglottic structures)
2. Hyoid bone tenderness

Question 11

What will be seen in an XR of Epiglottitis?

Answer 11

“Thumb sign”: shadow of enlarged epiglottis (confirms diagnosis)

Question 12

What will the bloods show in Epiglottitis? (2 things)

Answer 12

1. Raised WBC
2. Raised CRP

Question 13

What are the management options for Epiglottitis? (2 things)

Answer 13

1. Airway management (w humidified O2)
2. Abx: 3rd gen cephalosporin (if H influenzae)

Question 14

What are the complications of Epiglottitis? (4 things)

Answer 14

1. Airway obst
2. Oropharyngeal secretion aspiration
3. Cardiopulmonary arrest
4. Death