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Ear, nose and throat
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
CLINICAL FEATURES Child presents with general malaise, dysphagia, ‘quack-like’ cough and then stridor. Acute epiglottitis is an emergency as there is a danger of airway obstruction – very urgent ENT review (and an experienced anesthetist) will be needed – important not to look in throat as this can precipitate obstruction.
Neck
Published in A. Sahib El-Radhi, Paediatric Symptom and Sign Sorter, 2019
A toxic-looking child with high fever and swallowing difficulty has epiglottitis. Admit to intensive care unit (ICU), and consult an ENT surgeon and an anaesthetist. Do not examine the throat as this could cause laryngeal spasm and respiratory obstruction.
Head and neck infections
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
Muhammad Shakeel, AE Louise McMurran
Epiglottitis is an acute inflammation and oedema of the epiglottitis, generally caused by infection with Haemophilus influenza Type B (HIB). The incidence of this condition has decreased rapidly in the UK since the introduction in 1992 of the HIB vaccine to the vaccination schedule for children. In adults, the most common organism that causes acute epiglottitis is Haemophilus influenzae (25%), followed by H parainfluenzae, Streptococcus pneumoniae and group A Streptococci. Noninfectious causes of epiglottitis include thermal damage, caustic ingestion, foreign body impaction and expulsion, and chemotherapy for head and neck cancer.10
Lymphatic malformation in larynx masquerading as respiratory papillomatosis
Published in Acta Oto-Laryngologica Case Reports, 2021
Laryngeal lymphatic malformation is rare with a few literature mentioning larynx as an isolated site [4,6,7]. Lymphatic malformation from the cervicofacial region has a possibility of extension to the larynx. The largest series of 160 patients found laryngeal involvement in ten patients [6]. The diagnosis of lymphatic malformation is based on history, clinical findings, and imaging. In our case, the diagnosis initially was based on history and clinical assessment alone, so, the misdiagnosis of Juvenile respiratory Papillomatosis was made. The uncommon sites and presentations can be usually missed if the diagnosis is based on one modality. The presentation of stridor after an upper respiratory tract infection which was constant and showed no alteration during sleep or with activity-associated difficulty feeding was missed as laryngomalacia [7]. Some studies in adults even reported having symptoms suggestive of acute epiglottitis [8].
Prognostic factors and importance of recognition of adult croup
Published in Acta Oto-Laryngologica, 2018
Tomoyasu Tachibana, Yorihisa Orita, Takuma Makino, Yasutoshi Komatsubara, Yuko Matsuyama, Yuto Naoi, Michihiro Nakada, Yasuharu Sato, Kazunori Nishizaki
Epiglottitis is an acute life-threatening inflammatory condition involving the epiglottis and other supraglottic structures [16]. Unlike AC, antibiotics play an important role in the initial treatment of epiglottitis [16,17]. Although, the vast majority (70–90%) of adult patients with epiglottitis can be managed medically with close observation [17]. Epiglottitis and croup are often confused, especially in early phase of disorders, due to similarities in symptoms and signs, including stridor [18]. Coughing is a hallmark of croup, and 15 of 18 AC patients in this study had cough symptoms. However, the presence or absence of coughing in epiglottitis has been uncertain [18]. Although treatments differ between croup and epiglottitis, differentiation on presentation is difficult [19]. We speculate that the small number of manuscripts about AC may be partially attributable to misdiagnosis by physicians who cure AC patients using empirical treatments. Direct visualization of the larynx by laryngoscopic examination is indispensable to avoid misdiagnoses of diseases like severe epiglottitis or croup as common cold or pharyngitis. In particular, we should pay special attention to female, young age (<60 years), the symptom of cough, or high serum levels of CRP.
Breakthrough COVID-19 infection inducing acute epiglottitis in an immunized host
Published in Baylor University Medical Center Proceedings, 2022
Matthew Mitchell, Madison Buras, Mollie Shutter, J. Scott Wieters
Epiglottitis is a feared airway disease defined as inflammation of the epiglottis and surrounding supraglottic structures that commonly presents with fever, pharyngitis, dysphagia, and dyspnea and may progress to life-threatening airway obstruction requiring emergent intubation or tracheostomy.3,6,8,9 Impending airway obstruction may present as drooling, “hot potato voice,” stridor, retractions, supine position intolerance, and a posture of neck extension termed “sniffing position.” The patient should be kept calm to reduce airway dynamics and collapse. The airway should be directly visualized in the operating room to allow for a controlled setting for intubation.10