Acute epiglottitis: Difference between revisions

Latest revision as of 09:08, 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==
-= Definition =
-* Infection of the epiglottis
+*Infection of the epiglottis
+*See also [[chronic epiglottitis]]
+===Microbiology===
-= Etiology =
+*Pediatric
-* Paediatric
-** Haemophilus influenzae type B
+**''[[Haemophilus influenzae]]'' type B, before routine vaccination
-* Adult
+*Adult
-** Streptococcus pneumoniae
+**''[[Streptococcus pneumoniae]]''
-** Streptococcus pyogenes
+**''[[Streptococcus pyogenes]]''
-** Neisseria meningitidis
+**''[[Neisseria meningitidis]]''
+*Cryptogenic (now most common)
+==Clinical Manifestations==
-= Differential Diagnosis =
+*In children, presents with fever, irritability, and respiratory distress with or without stridor
-* Viral croup
+**Often a muffled, hoarse voice
-* Bacterial tracheitis
+**Cough is rare
-* Thermal epiglottitis
+*In adults, presents with odynophagia and sore throat
-* Angioneurotic edema
+**May also have fever, drooling, or stridor
-* Retropharyngeal abscess
-* Peritonsillar abscess
-* Uvulitis
-* Diphtheria
+==Differential Diagnosis==
-= Presentation =
+*Viral croup
-* Paediatric
+*Bacterial tracheitis
-** Toxic, febrile child with muffled voice and possibly tripoding
+*Thermal epiglottitis
-** Cough is rare
+*Angioneurotic edema
-* Adult
+*[[Retropharyngeal abscess]]
-** Odynophagia and sore throat are cardinal features
+*[[Peritonsillar abscess]]
-** Can also have fever, drooling, or stridor
+*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]]