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Acute Epiglottitis (AE)


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 



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    


  • Azithromycin (PO) 500mg once daily for 3 days. Children: 10mg/kg once daily for 3 days     


  •  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;     


  • Paracetamol (PO) 1gm 8hourly until fever is controlled. Children: 10 mg/kg body weight 8 hourly 

Updated on, 30.10.2020


1. STG 

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