Epiglottitis
| Since the Hib vaccine, more often an illness of adulthood | |
|---|---|
| Etiology | Hib, Strep pneumo |
| Epidemiology | Epid: M>F in kids. |
| Clinical presentation | impending airway disaster... in an unvaccinated child? ➥ Rapid onset aphasia/dysphagia (drooling) ➥ Rapid onset laryngeal voice change ➥ systemically unwell ➥ Rapid onset (within 24h) ➥ holding head and neck in extension +/- trismus/torticollis (collection in deep neck space) ⇒ sore throat + torticollis or neck swelling + torticollis = call ENT |
| Pathogenesis | |
| Diagnostic investigations | Ddx: retropharyngeal abscess, Ludwig’s angina |
| Management | ➥ In kids: "place of safety" - theatre/anaesthetic room in case intubation needed... though not routinely needed ➥ IV ceftriaxone ➥ Adrenaline neb, IV dexamethasone (↓ airway oedema) ➥ Red flags for impending airway doom: neck stiffness, stridor, tripoding |
| Complications | Retropharyngeal abscess - sore throat, fever, neck stiffness, stridor |