Epiglottitis: Difference between revisions

Revision as of 12:30, 21 November 2011

Otolaryngologic emergency
- Can lead to rapid onset of life-threatening airway obstruction
Most cases are seen in adults (since advent of H. flu vaccine)
Etiology
- Strep, staph, H. flu (unvaccinated)
- Caustic burns

Imaging only required if diagnosis uncertain
Lateral neck x-ray
- Obliteration of vallecula
- Edema of prevertebral and retropharyngeal soft tissues
- "Thumb sign" (enlarged epiglottis)

Tintinalli

Authors:

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 ==Background==
+*Otolaryngologic emergency
+**Can lead to rapid onset of life-threatening airway obstruction
+*Most cases are seen in adults (since advent of H. flu vaccine)
 *Etiology
-**Strep, staph, H. flu (unvaccinated), candida (immunosuppressed)
+**Strep, staph, H. flu (unvaccinated)
 **Caustic burns
+==Clinical Features==
+*Three D's:
+**Drooling
+**Dysphagia
+**Distress
+*Pain with gentle palpation of larynx and upper trachea
+*Stridor
+*Respiratory distress
 ==Diagnosis==
-*Abrupt onset of fever, drooling, sore throat
+*Imaging only required if diagnosis uncertain
-**May progress rapidly to stridor, respiratory distress
+*Lateral neck x-ray
+**Obliteration of vallecula
-==Work-Up==
+**Edema of prevertebral and retropharyngeal soft tissues
-*Lateral neck xray
+**"Thumb sign" (enlarged epiglottis)
-**Only obtain if dx uncertain
-**"Thumb sign"
 ==Treatment==
-*O2
+*Emergent ENT consult
-*Epinephrine (nebulized)
+*O2 (humidified)
+*IVF (hydration minimizes crusting in the airway)
+*Abx
+**CTX 2gm IV
 *Steroids
-*Abx
+**Methylprednisolone 125mg IV
-**(Cefuroxime or CTX) + vanco
+*Intubation or cricothyrotomy
 ==Disposition==
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 [[Category:Peds]]
+[[Category:ID]]