Epiglottitis

Respiratory (12%) Core Clinical Conditions

1B The Physician Associate is able to identify the condition as a possible diagnosis: may not have the knowledge/resources to confirm the diagnosis or to manage the condition safely, but can take measures to avoid immediate deterioration and refer appropriately

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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management

Epiglottitis is a severe epiglottal inflammation and swelling caused by a bacterial infection.

• Haemophilus influenzae. 

• Can be caused by a viral infection also such influenza virus or herpes simplex virus. 

• Trauma to the neck.

1. The bacteria or virus infiltrates the airways > inflammatory response > swelling and redness.  

2. Obstruction of airways > SOB, wheeze and stridor. 

3. Increased risk of infection > impaired swallowing.

• Children are more at risk age 2 - 6. 

• Weak immune system.

• Previous infections can increase risk of epiglottitis. 

• Smoking. 

• Trauma to throat/neck. 

• Unvaccinated. 

• Chronic lung conditions such as asthma / COPD.

• Inspiratory stridor

• Restlessness, cough, SOB, fever and drooling. 

• Remember the 4 D’s: dysphagia, drooling, odynophagia and respiratory distress. 

• O/E: fever, tachycardia, tachypnoea, cyanosis.

• Refer urgently to ENT.

• Laryngoscopy: cherry red epiglottis. 

• Neck x-ray: thumbprint Sign.

• CT scan: may show obstruction.

• Airway management is generally done by ENT / anaesthetic + oxygen therapy.

• IV antibiotics (ceftriaxone) + steroids to reduce swelling. 

•  Immunisation to prevent.

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