Podcast # 487: Hunting for Epiglottitis

Contributor: Michael Hunt, MD

Educational Pearls:

• Due to the efficacy of vaccination, epiglottitis is now more common in adults than children
• Risk factors include smoking and other immunocompromising co-morbidities, such as diabetes
• Epiglottitis can present with sore throat and fever, with potential rapid progression to respiratory distress and stridor
• Diagnosis can include x-ray to look for the "thumbprint sign," nasofiberoptics, and/or CT
• Antibiotics are mainstay of treatment but severe cases may need establishment of a definitive airway, typically done with fiberoptics in the operating room due to the potential to irritate the epiglottitis with traditional laryngoscopy

References

Li RM, Kiemeney M. Infections of the Neck. Emerg Med Clin North Am. 2019 Feb;37(1):95-107. doi: 10.1016/j.emc.2018.09.003. Review. PubMed PMID: 30454783.

Tsai YT, Huang EI, Chang GH, Tsai MS, Hsu CM, Yang YH, Lin MH, Liu CY, Li HY. Risk of acute epiglottitis in patients with preexisting diabetes mellitus: A population-based case-control study. PLoS One. 2018;13(6):e0199036. doi: 10.1371/journal.pone.0199036. eCollection 2018. PubMed PMID: 29889887; PubMed Central PMCID: PMC5995441.

Guerra AM, Waseem M. Epiglottitis. [Updated 2018 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430960/

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD