Reviews here, here and JAMA case series here.While the introduction of the Haemophilus influenzae type B vaccine has reduced the incidence in children, acute epiglotitis continues to occur in adults.
Patients present with sore throat, odynophagia , fever, dyspnea, drooling, dysphagia, foreign body sensation, and stridor.
Diagnosis can be made on the lateral neck radiograph (thumb-print sign) or on direct fiberoptic laryngoscopy.
The most common pathogens are oral flora including non-typable haemophilus species and group A streptococci. Treatment includes a third generation cephalosporin in association with close monitoring and airway management. Steroids (dexamethasone) are commonly used to decrease swelling, but the evidence for their use is actually limited.
About 40-50% will need invasive airway management (intubation, tracheostomy)
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