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Epiglottitis

The most common cause is H. Influenzae B (Hib). It's an emergency as it can swell and completely obstruct airways within hours. Is prevented with the Hib vaccine.

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“Epiglottitis endoscopy” © 藤澤孝志 CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/)

Presentation:

  • Drooling

  • Stridor

  • Sore throat

  • Fever

  • Dyphagia/odynophagia


Investigations:

  • Don’t examine or upset the patient - may worsen the obstruction

  • Lateral XR - Thumbprint sign

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“Left column: Normal epiglottis. Right column: Epiglottitis.” © Med Chaos CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/)

N.B. If epiglottitis is suspected, don’t wait for investigations, and instead treat straight away.


Management:

  • Immediate referal to ENT and anaesthetics

  • Secure airways

  • IV Ceftriaxone

  • Dexamethasone



N.B. Public health have to be notified.




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