Question

Epiglottis disease affects the respiratory system in some way, please include this information in your written discussion. Thank you.

1. Etiology (What caused it)

2. Clinical Manifestations (How it presents signs and symptoms)

3.  Diagnosis (Tests, X-Rays, etc.) specific identifying characteristics specific to this disease

4.  Treatment (Medications, therapy’s)

Answer 1

ETIOLOGY

The most common organism that cause epiglottitis are Heamophilus influenzae, followed by H parainfluenzae, Streptococcus pneumoniae, and group A streptococci.

SIGNS AND SYMPTOMS

• Tripod position- sitting up on hands, with the tongue out and the head forward.
• Drooling/ inability to handle secretions.
• Stridor - A late finding indicating advanced airway obstruction.
• Muffled voice
• Cervical adenopathy
• Fever
• Hypoxia
• Respiratory distress

DIAGNOSIS

• Unlike in children, indirect laryngoscopy is generally safe and may demonstrate a swollen, erythematous epiglottis.
• Lateral plain radiographs may demonstrate an enlarged epiglottis (the epiglottis " thumb sign").

TREATMENT

Initial treatment is hospitalization for intravenous antibiotics

• Ceftizoxime, 1-2g intravenously every 8-12 hours, or
• Cefuroxime, 750-1500g intravenously every 8 hours; and
• Dexamethasone , usually 4-10mg as initial bolus, then 4mg intravenously every 6 hours and observation of the airway.
• Corticosteriods may be tappered as symptoms and signs resolve.
• Less than 10% of adults require intubation.
• Indications for intubation are dyspnea, rapid pace of sore throat and endolaryngeal abscess noted on CT imaging.
• If the patient is not intubated, prudence suggests monitoring oxygen saturation with continous pulse oximetry and initial admission to a monitored unit.