Acute epiglottitis

• Infection of the epiglottis

Etiology

• Paediatric
  • Haemophilus influenzae type B
• Adult
  • Streptococcus pneumoniae
  • Streptococcus pyogenes
  • Neisseria meningitidis

Differential Diagnosis

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

Clinical Manifestations

• 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

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