Acute Epiglottitis (AE)

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Epiglottitis is an acute infectious inflammation of the epiglottis, supraglottic and hypopharynx which occurs both in children and adults. It is commonly caused by Haemophilus influenzae. Epiglottitis is a potentially lethal condition especially in children. Edema of the epiglottis may cause acute airway
obstruction.

Clinical presentation

  • Throat pain and difficulty in swallowing
  • Drooling
  • Husky voice
  • Fever often high and with chills
  • Patient  prefers  sitting  posture  with an extended neck
  • Laborious inspiration
  • Cough in some cases
  • Anxiety

Investigations:

Plain X-ray of the neck, lateral view characteristically presents with a positive thumb  sign (edematous epiglottis). 

Non-pharmacological Treatment: 

  • Immediate hospitalization, preferably in the ICU
  • Transportation: sitting, with oxygen supplementation
  • Be prepared to treat respiratory failure (intubation or tracheotomy)

Pharmacological Treatment 

B: azithromycin (PO) 500mg 24hourly for 3days. Children: 10mg/kg 24hourly for 3days 

OR 

B: amoxicillin + clavulanic acid (PO)(FDC) Adults: 625mg 8hourly Children: 375mg 12hourly for 7days

AND 

A: paracetamol (PO) 1gm 8hourly until fever is controlled. Children: 10 mg/kg body weight 8hourly