Acute Epiglottitis – From Hospital Visit to Death in Just 10 Minutes! This Sore Throat Isn’t Just a Cold or ‘Heatiness’—Don’t Ignore It!

Acute epiglottitis is a life-threatening infection of the epiglottis and surrounding tissues, characterized by rapid inflammation and swelling that can lead to airway obstruction. Below is a detailed breakdown of the condition:

I. Key Points

1. Causes
   • Infection: Most commonly caused by Haemophilus influenzae type B (Hib), but other pathogens like Streptococcus pneumoniae and Staphylococcus aureus may also be responsible.
   • Other factors: Trauma (e.g., hot liquid burns), allergic reactions, or chemical irritation.
   • Note: Hib vaccination has significantly reduced cases in children, making adult cases more prevalent.
2. Symptoms
   • Severe throat pain: Worsens with swallowing, often accompanied by drooling.
   • Respiratory distress: Stridor (high-pitched breathing sound), retractions, and potential suffocation due to epiglottic swelling.
   • Systemic signs: High fever (>38.5°C), chills, and fatigue.
   • Classic sign: Patients may assume a “tripod position” (leaning forward) to maintain airflow.
3. Complications
   • Acute upper airway obstruction (requires emergency intubation or tracheostomy).
   • Spread of infection (e.g., Ludwig’s angina, mediastinitis).

II. Diagnosis & Treatment

1. Diagnosis
   • Laryngoscopy: Reveals a swollen, cherry-red epiglottis (perform with caution to avoid triggering obstruction).
   • Imaging: Lateral neck X-ray may show the “thumb sign” (thickened epiglottis).
   • Lab tests: Elevated white blood cells, blood cultures.
2. Emergency Management
   • Secure the airway: Immediate hospitalization with readiness for intubation or cricothyrotomy.
   • Medications :
     • IV antibiotics (e.g., third-gen cephalosporins: cefotaxime/ceftriaxone).
     • Corticosteroids (dexamethasone) to reduce edema.
     • Epinephrine nebulization if needed.
3. Prevention
   • Hib vaccination (especially for children and immunocompromised individuals).
   • Avoid throat trauma or inhalation of irritants.

III. Important Notes

• Avoid: Sedatives, direct throat examination (e.g., tongue depressor), or supine positioning—may worsen obstruction.
• Prognosis: With prompt treatment, recovery is likely; delay increases mortality risk (6–10%).

Warning: Seek emergency care immediately if sudden severe throat pain and breathing difficulty occur!