Difference between revisions of "Epiglottitis"
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Epiglottitis is inflammation of the epiglottis typically secondary to an infectious process. The most common causative bacterium historically was Haemophilus influenzae type B. However, with the advancement of vaccination, other causative agents such as Streptococcus pneumoniae or viruses are now more common. | |||
Traditionally, children ages 2-5 years of age were most likely to present with epiglottitis. However, older children and adults may also be afflicted. | |||
== Anesthetic implications<!-- Briefly summarize the anesthetic implications of this comorbidity. --> == | == Anesthetic implications<!-- Briefly summarize the anesthetic implications of this comorbidity. --> == | ||
=== Preoperative optimization<!-- | === Preoperative optimization<!-- The most important goal is expeditious and safe transport to a controlled environment (the OR) to secure the airway. Thorough airway examination should be avoided for children due to the possibility of agitation and worsening of airway obstruction. The child should be transported to the OR with pulse oximetry, oxygen support via face mask or nasal cannula, emergency airway equipment including surgical airway instruments, and a physician experienced in airway management such as an anesthesiologist or otolaryngologist. Parents may be allowed to accompany a child if this avoids agitation. If an IV is present, glycopyrolate may be administered to reduce secretions. -->=== | ||
=== Intraoperative management<!-- | === Intraoperative management<!-- Emergency airway equipment including a difficult airway cart, video laryngoscope, flexible bronchoscope, and appropriately sized endotracheal tubes must be available. An ENT must be present at induction if the need for a surgical airway arises. For an adult patient, awake airway should be attempted. For a child who cannot tolerate awake airway, induction should occur in the seated position to avoid airway obstruction, potentially on the parent's lap if this helps to prevent agitation and distress. Induction with 100% FIO2 and sevoflurane to maintain spontaneous respiration is critical. Parents should be escorted from the OR once the child has reached an appropriate plan of anesthesia. Anticipate increased secretions and friable oropharyngeal tissue secondary to the infection. -->=== | ||
=== Postoperative management<!-- Describe how this comorbidity may influence postoperative management. --> === | === Postoperative management<!-- Describe how this comorbidity may influence postoperative management. --> === | ||
Latest revision as of 07:03, 25 January 2026
| Anesthetic relevance |
High |
|---|---|
| Anesthetic management |
Inhalational induction to maintain spontaneous respirations; Immediate securement of the patient's airway in the operating room due to high risk for critical airway obstruction |
| Specialty |
ENT |
| Signs and symptoms |
- The 4 "D's": dyspnea, dysphagia, drooling, dysphonia - typically presents in children age 2-5 years - Fever as high as 40 degreees Celcius |
| Diagnosis |
Clinical suspicion; "thumb print" sign on lateral neck X-ray |
| Treatment |
Emergent securement of the airway, subsequent antibiotics and steroids |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Epiglottitis is inflammation of the epiglottis typically secondary to an infectious process. The most common causative bacterium historically was Haemophilus influenzae type B. However, with the advancement of vaccination, other causative agents such as Streptococcus pneumoniae or viruses are now more common.
Traditionally, children ages 2-5 years of age were most likely to present with epiglottitis. However, older children and adults may also be afflicted.
Anesthetic implications
Preoperative optimization
Intraoperative management
Postoperative management
Related surgical procedures
Pathophysiology
Signs and symptoms
Diagnosis
Treatment
Medication
Surgery
Prognosis
Epidemiology
References
Top contributors: Olivia Sonderman and Mitchel DeVita