Guidelines
Acute Epiglottitis

Acute Epiglottitis

Background

An acute inflammation of the epiglottis, a rare but serious disease of young children. Airway obstruction is always severe, and intubation or tracheostomy is often needed. It is rare since routine childhood immunisation with Hib vaccine was introduced

  • Rapid onset of high fever
  • Typical: ”tripod or sniffing ” position, preferring to sit, leaning forward with an open mouth, appears anxious
  • Sore throat, difficulty swallowing, drooling, respiratory distress
  • Stridor and maybe cough
  • Appears critically ill (weak, grunting, crying, drowsy, does not smile, anxious gaze, pallor, cyanosis)
  • Asphyxia leading to quick death

Laryngeal cause of stridor e.g. laryngotracheobronchitis

  • Avoid tongue depression examination as this may cause complete airway blockage and sudden death
  • Do not force child to lie down as it may precipitate airway obstruction

Management