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Epiglottitis

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  1. Epidemiology
    1. Commonly misdiagnosed as croup (20% in some studies)
    2. Average age is older than that seen in Croup (Age 2-5)
  2. Definition
    1. Potentially fatal infection of supraglottic tissue
  3. Etiology
    1. Children
      1. Haemophilus Influenzae type B
    2. Adults
      1. Group A beta hemolytic Streptococcus
      2. Streptococcus Pneumoniae
      3. Haemophilus Influenzae
  4. Symptoms (Acute onset with rapid progression)
    1. Initial Symptoms
      1. Severe Pharyngitis (82%)
      2. Fever
    2. Mild or subtle Stridor (77%)
      1. "Look worse then they sound" (opposite of Croup)
    3. Shortness of Breath (100%)
    4. Irritability or restlessness (46%)
    5. Dysphagia (64%)
    6. Drooling (41%)
    7. Soft muffled voice or Hoarseness (31%)
  5. Diagnosis (Differentiate from Croup)
    1. Absence of cough
    2. Dysphagia (difficult swallowing with Drooling
    3. Toxic appearance
  6. Labs
    1. Complete Blood Count with Leukocytosis
  7. Radiology: Lateral Neck XRay
    1. Thumb shaped epiglottis (swollen supraglottis)
    2. Diminished vallecula
  8. Management
    1. Avoid Tongue depressor or other oral instruments
      1. Epiglottis irritation may lead to obstruction
    2. Keep patient calm
    3. Third Generation Cephalosporin (e.g. Rocephin)
    4. Controlled intubation by anesthesia or Otolaryngology
      1. Epiglottis inspection under anesthesia (fiery red)
      2. Culture epiglottis if possible
    5. Avoid potentially harmful therapies
      1. Avoid Racemic Epinephrine
      2. Avoid Systemic Steroids
  9. References
    1. Cressman (1994) Pediatr Clin North Am 41(2):265
    2. Pappas (1997) Consultant, April 1997:857-67

Epiglottitis (C0014541)

Definition (MSH)Inflammation of the epiglottis.
ConceptsDisease or Syndrome (T047)
MSHD004826
EnglishEpiglottitides, Epiglottitis
Spanishepiglotitis
Parent ConceptsLaryngitis (C0023067), Disorder of epiglottis (C1290333)
SourcesCOSTAR, DXP, MSH, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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