Epiglottitis

Inflammation of the epiglottis

Aetiology

  • Historically most often caused by H. influenza type B but with the availability of immunization this is no longer the case
  • Bacteria most often causing infection presently are Streptococcus pneumoniae, Streptococcus pyogenes, or Staphylococcus aureus

Clinical presentation

Symptoms

  • Severe sore throat
  • Drooling saliva
  • Pyrexia

Signs

  • Examination of oral cavity is normal - no inflammation of tonsils
  • May have stridor

Investigations

  • Clinical diagnosis
  • Because of the risk of inducing laryngeal spasm and/or total airway obstruction, examination of the pharynx and larynx should be attempted only in an area with adequate equipment and staff prepared to intervene should upper airway obstruction develop

Management

Mild

  • Supportive
  • Antibiotics
  • Nebulisers (adrenaline/saline)
  • Corticosteroids

More severe

  • Antibiotics
  • Intubation and ventilation
  • Tracheostomy