Acute epiglottitis

Question 1

Epiglottitis involves inflammation and swelling of the epiglottis usually due to…

Answer 1

infection

Question 2

True or false: Epiglottitis is a life-threatening emergency

Answer 2

True

Question 3

WHat are the 2 key causes of epiglottitis?

Answer 3

Haemophilus influenzae type B (now vaccination)
Streptococcus pneumoniae

Question 4

What is the typical age for epiglottitis to present?

Answer 4

2-7 y/o

Question 5

What condition can epiglottitis present similarly too?

Answer 5

Croup
But has a more rapid onset

Question 6

What are typical symptoms of epiglottitis?

Answer 6

Sore throat
Dysphagia
Painful swallowing (odynophagia)
High fever
Stridor
Drooling
Muffled “hot potato” voice

Question 7

Suspect epilottitis in an u_______ child with a high fever, sore throat, d____ and d_____.

Answer 7

unvaccinated
dysphagia and drooling

Question 8

What investigations should be taken for suspected epiglottitis?

Answer 8

None as may scare the child and worsen the airway obstruction.

Can do lateral x-ray of neck shows “thumb sign” - soft tissue shadow looks like a thumb pressed into trachea

Question 9

How is epiglottitis managed?

Answer 9

Avoid upsetting child
Don’t examine
Alert most senior paediatrician and anaesthetist
Oxygen may be administered by holding mask close, but don’t put it on
Prepare to intubate
May need to do tracheostomy if airway closes

IV antibiotics once airway secure eg ceftriaxone

Consider systemic steroids