Acute epiglottitis: Difference between revisions

Revision as of 09:05, 18 August 2020

Background

Infection of the epiglottis

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