By ULY CLINIC
Acute Epiglottitis (AE)
​
Introduction
​
Epiglottitis is an acute infectious inflammation of the epiglottis, supraglottic and hypopharynx which occurs both in children and adults. It is commonly caused by Haemophilus influenzae. Epiglottitis is a potentially lethal condition especially in children. Edema of the epiglottis may cause acute airway obstruction.
​
Diagnostic Criteria
​
-
Throat pain and difficulty in swallowing
-
Drooling
-
Husky voice
-
Fever often high and with chills
-
Patient prefers sitting posture with an extended neck
-
Laborious inspiration
-
Cough in some cases
-
Anxiety
Investigations:
​
Plain X-ray of the neck, lateral view characteristically presents with a positive thumb sign (edematous epiglottis).
​
Non-Pharmacological Treatment:
​
-
Immediate hospitalization, preferably in the ICU
-
Transportation: sitting, with oxygen supplementation
-
Be prepared to treat respiratory failure (intubation or tracheotomy)
​
Pharmacological Treatment
-
Phenoxymethylpenicillin (PO) 500mg 8 hourly for 7 days. Children up to 5 years: 6 mg/kg 6 hourly for 10 days
OR
-
Azithromycin (PO) 500mg once daily for 3 days. Children: 10mg/kg once daily for 3 days
OR
-
Amoxicillin/Clavulanic acid (PO) Adults: 625mg (500mg amoxicillin+125mg Clavulanic acid) 8 hourly for 7 days Children: 375mg (250mg amoxicillin+125 Clavulanic acid) 12 hourly for 7 days;
AND
-
Paracetamol (PO) 1gm 8hourly until fever is controlled. Children: 10 mg/kg body weight 8 hourly
​
Updated on, 30.10.2020
​
​
References
​
1. STG