Of the 40 children presenting with epiglottitis, eight (20%) presented after the introduction of the Hib conjugate vaccine. [ncbi.nlm.nih.gov]

• Fever

  She presented with high fever, arthralgia, general fatigue and strong throat pain. Laryngeal fiberscopy showed a markedly swollen epiglottis suggestive of acute epiglottitis, though she had no signs of asphyxia. [ncbi.nlm.nih.gov]

• Pediatric Disease

  Before the widespread use of its conjugated immunization, Haemophilus influenza type b was the most common cause and it was usually thought of as a pediatric disease process. [pediatriceducation.org]

• Malaise

  Symptoms usually progress slowly and may be associated with chest pain, neck pain, fatigue, malaise, unexplained fever, or weight loss. [ahcmedia.com]

  Symptoms of sore throat from either a viral or bacterial infection can be generalized symptoms that occur throughout the body such as fever, headache, nausea, and malaise. [emedicinehealth.com]

• Stridor

  The incidences of drooling, stridor/dyspnea, and muffled voice were significantly higher in the airway-supported group ( P 0.05). Stridor/dyspnea is a reliable clinical predictor of airway compromise (odds ratio 2.94; P 0.0277). [ncbi.nlm.nih.gov]

  Factors thought to predict the need of intervention include dyspnea; drooling; stridor and sitting erect, or stridor and drooling; a rapid onset of symptoms; and a history of diabetes mellitus. [prognosisapp.com]

• Cough

  Cover your mouth when you sneeze or cough. Wash your hands after you cough, sneeze, or use the bathroom. Ask your healthcare provider if other family or household members need antibiotic medicine to prevent infection. [drugs.com]

  Other problems that affect the throat include Tonsillitis - inflammation of the tonsils Cancer Croup - inflammation, usually in small children, which causes a barking cough Laryngitis - swelling of the voice box, which can cause a hoarse voice or loss [icdlist.com]

  Signs and symptoms of epiglottitis include inspiratory stridor, restlessness, cough, dyspnea, fever, and drooling. [smartypance.com]

  - Other signs and symptoms include the following: - Dyspnoea; - Stridor; - Dysphonia; - Drooling; - Tachycardia; - Tachypnoea; - Hypoxia; - Cough. - If the airways become totally blocked and emergency treatment is not provided, acute epiglottitis can [nursingtimes.net]

• Hoarseness

  Other important clinical factors to consider are odynophagia, drooling, hoarseness, muffled voice, dyspnoea, swelling of the posterior side of the epiglottis and a high WBC count. [ncbi.nlm.nih.gov]

  Sore throat and hoarseness, frequently with a high fever, develop abruptly in a previously well individual. [medicinenet.com]

• Inspiratory Stridor

  Additionally, airway patency should be established when inspiratory stridor appears assuring uncomplicated recovery. [ncbi.nlm.nih.gov]

  Signs and symptoms of epiglottitis include inspiratory stridor, restlessness, cough, dyspnea, fever, and drooling. [smartypance.com]

  The first signs-sore throat, hoarseness, fever, and dysphagia-may be followed by an inability to swallow, drooling, varying degrees of dyspnea, inspiratory stridor, marked irritability and apprehension, and a tendency to sit upright and hyperextend the [medical-dictionary.thefreedictionary.com]

• Bronchial Breath Sounds

  Lung auscultation may reveal crepitations or bronchial breath sounds if there is associated pneumonia. B. Laboratory Findings. The white blood cell count is elevated with a polymorphonuclear reaction. [internalmedicinejournal.blogspot.com]

• Odynophagia

  Other important clinical factors to consider are odynophagia, drooling, hoarseness, muffled voice, dyspnoea, swelling of the posterior side of the epiglottis and a high WBC count. [ncbi.nlm.nih.gov]

  Acute epiglottitis should be suspected in all patients with a history of sore throat and odynophagia, especially if symptoms are out of proportion to pharyngel findings. [arquivosdeorl.org.br]

  Diagnosis in adults may be delayed a sore throat and odynophagia are the only complaints and they do not have signs and symptoms of airway obstruction. [waent.org]

• Gagging

  Indirect laryngoscopy should be done with caution since patient gagging may worsen or participate catastrophic airway obstruction. [waent.org]

  In our case, oral local anesthetic spray did not completely abolish gag reflexes and pain. Gag reflex, due to moderate discomfort during fiberoptic intubation, traumatized the pharynx but fortunately left the abscess intact [Figure 3]. [joacp.org]

Workup Airway management is the most urgent consideration, and patients should first be assessed for level of distress before any other workup. [emedicine.com]

• Subglottic Narrowing

  narrowing and ballooning of hypopharynx no epiglottis thickening inhaled foreign bodies pharyngitis pneumonia peritonsillar abscess retropharyngeal abscess usually clinical following tonsillitis bacterial tracheitis asymmetric subglottic narrowing (intraluminal [radiopaedia.org]

  narrowing (steeple sign) and a normal-sized epiglottis *Also called viral laryngotracheal bronchitis. [merckmanuals.com]

  Chest radiographs may show subglottic narrowing (in 50% of children with croup), but this can also be seen in normal patients. [hawaii.edu]

  Weppner, DO Figure 4: CT Scan of the Neck Revealing Swelling Epiglottis and Aryepiglottic Folds with Significant Subglottic Narrowing From the collection of Justin L. [ahcmedia.com]

• Blood Culture Positive

  Study by Wong et alalso revealed three blood cultures positive ( Haemophilus influenza in two cases and streptococcus mitis in one case) out of 14 cases (11). However Hugosson et al (9) study quoted 68% as a negative blood cultures. [arquivosdeorl.org.br]

  It is noteworthy that two of the electively intubated patients had blood cultures positive for H. influenzae, whereas none of the conservatively treated patients did. Limitations of Our Study First, our study is a retrospective review. [anesthesiology.pubs.asahq.org]

The purpose of this study was to retrospectively analyze diagnostic and treatment methods in adults with epiglottitis seen over a 10-year period at the Winnipeg Health Sciences Centre. [ncbi.nlm.nih.gov]

Prognosis: • The prognosis in adults with acute epiglottitis is good with appropriate and timely treatment. • Most patients can be extubated within several days. • However, unrecognized epiglottitis may rapidly lead to airway compromise and resultant [slideshare.net]

In general, the prognosis is good with antimicrobial therapy, close monitoring and selective airway intervention. [ncbi.nlm.nih.gov]

Prognosis The prognosis in adults with acute epiglottitis is good with appropriate and timely treatment. Most patients can be extubated within several days. [emedicine.com]

Prognosis Expeditious diagnosis, immediate management of upper-airway obstruction, and institution of antibiotics decreases morbidity and mortality related to acute epiglottitis. Full recovery without sequelae is expected in such patients. [internalmedicinejournal.blogspot.com]

Among the 158 cases, the infectious etiology was identified in 29 (H. influenzae 20, Streptococcus pneumoniae six, H. parainfluenzae two, Streptococcus pyogenes one). In the remaining cases, the etiology was uncertain. [ncbi.nlm.nih.gov]

When an etiologic agent is identified, it is usually Hemophilus influenzae. [shmabstracts.com]

In fact, this organism is the most common etiologic agent associated with epiglottitis, which has a thumbprint sign seen on X-ray. Ceftriaxone antibiotic is commonly used for treatment in severe cases. [smartypance.com]

Abstract Over a period of 18 years 219 consecutive cases of acute epiglottitis were diagnosed and subsequently investigated in order to elucidate the aetiology, epidemiology and outcome of this disease in a well-defined population in Sweden before general [ncbi.nlm.nih.gov]

The dramatic change in the epidemiology of pediatric epiglottitis. Pediatr Emerg Care 2006 ; 22 : 443 –4 6 Torkkeli, T, Ruoppi, P, Nuutinen, J, Kari, A. [cambridge.org]

Epidemiology of Haemophillus influenzae Type B disease and impact of Haemophillus influenza Type B conjugate vaccine in the United States and Canada. Paediatr Iinfect Dis J. 1998 Sep;17(9 Suppl):S132-6. View Abstract 3. [waent.org]

After the third recurrence, careful consideration was given to possible pathophysiologic mechanisms and potential therapeutic options. Further recurrence was prevented effectively by performing a lingual tonsillectomy. [ncbi.nlm.nih.gov]

Risk factors in adults include hypertension, diabetes mellitus, substance abuse, immune deficiency, and airway trauma. return to top Pathophysiology Infectious epiglottitis results from bacteremia or from direct spread to the epithelial layer of the epiglottis [sharinginhealth.ca]

It is important for anaesthetists and intensive care specialists to be able to manage upper airway obstruction resulting from acute epiglottitis and have a clear understanding of the aetiology and the pathophysiology of this condition. [ispub.com]

Pathophysiology, evaluation and treatment of the difficult airway. Anesth Clin North Am 1998;16:29-75. 6. Muller BJ, Fliegel JE. Acute epiglottitis in a 79-year-old man. Can Anaesth Soc J 1985;32:415-7. [ PUBMED ] [Figure 1], [Figure 2], [Figure 3] [joacp.org]

[…] also been described in an adult receiving infliximab, prednisone, and azathioprine for Crohn’s disease. 47 Noninfectious causes of epiglottitis should also be considered, including thermal injury, foreign body ingestion, and caustic ingestion. 48-50 Pathophysiology [ahcmedia.com]

Lingual tonsillectomy in these cases may help prevent further recurrent episodes. [ncbi.nlm.nih.gov]