Acute epiglottitis: Difference between revisions

Latest revision as of 13:08, 18 August 2020

Background

Infection of the epiglottis
See also chronic epiglottitis

Microbiology

Pediatric
- Haemophilus influenzae type B, before routine vaccination
Adult
Cryptogenic (now most common)

Clinical Manifestations

In children, presents with fever, irritability, and respiratory distress with or without stridor
- Often a muffled, hoarse voice
- Cough is rare
In adults, presents with odynophagia and sore throat
- May also have fever, drooling, or stridor

Differential Diagnosis

Viral croup
Bacterial tracheitis
Thermal epiglottitis
Angioneurotic edema
Retropharyngeal abscess
Peritonsillar abscess
Uvulitis
Diphtheria

Investigations

Lateral neck x-ray shows thumb sign
Laryngoscopy

Management

Ceftriaxone
Include Staph aureus coverage if concerned for bacterial tracheitis
Vanco to cover resistant pneumococcus if common
7-10 days

@@ Line 1: / Line 1: @@
+==Background==
-= Epiglottitis =
+*Infection of the epiglottis
-== Definition ==
+*See also [[chronic epiglottitis]]
+===Microbiology===
-* Infection of the epiglottis
+*Pediatric
-== Etiology ==
+**''[[Haemophilus influenzae]]'' type B, before routine vaccination
+*Adult
+**''[[Streptococcus pneumoniae]]''
+**''[[Streptococcus pyogenes]]''
+**''[[Neisseria meningitidis]]''
+*Cryptogenic (now most common)
+==Clinical Manifestations==
-* Paediatric
-** Haemophilus influenzae type B
-* Adult
-** Streptococcus pneumoniae
-** Streptococcus pyogenes
-** Neisseria meningitidis
+*In children, presents with fever, irritability, and respiratory distress with or without stridor
-== Differential Diagnosis ==
+**Often a muffled, hoarse voice
+**Cough is rare
+*In adults, presents with odynophagia and sore throat
+**May also have fever, drooling, or stridor
+==Differential Diagnosis==
-* Viral croup
-* Bacterial tracheitis
-* Thermal epiglottitis
-* Angioneurotic edema
-* Retropharyngeal abscess
-* Peritonsillar abscess
-* Uvulitis
-* Diphtheria
+*Viral croup
-== Presentation ==
+*Bacterial tracheitis
+*Thermal epiglottitis
+*Angioneurotic edema
+*[[Retropharyngeal abscess]]
+*[[Peritonsillar abscess]]
+*Uvulitis
+*[[Diphtheria]]
+==Investigations==
-* Paediatric
-** Toxic, febrile child with muffled voice and possibly tripoding
-** Cough is rare
-* Adult
-** Odynophagia and sore throat are cardinal features
-** Can also have fever, drooling, or stridor
+*Lateral neck x-ray shows thumb sign
-== Investigations ==
+*Laryngoscopy
+==Management==
-* Lateral neck x-ray shows thumb sign
-* Laryngoscopy
+*Ceftriaxone
-== Management ==
+*Include Staph aureus coverage if concerned for bacterial tracheitis
+*Vanco to cover resistant pneumococcus if common
+*7-10 days
+[[Category:Head and neck infections]]
-* Ceftriaxone
+[[Category:Pediatrics]]
-* Include Staph aureus coverage if concerned for bacterial tracheitis
-* Vanco to cover resistant pneumococcus if common
-* 7-10 days