Epiglottitis

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Summary 1) Robbins Basic Pathology by Vinay Kumar

Epiglottitis is an inflammation of the epiglottis  the flap at the base of the tongue that keeps food from going into the trachea (windpipe).

Pathophysiology 2) Emedicine

CT imaging show “halloween sign”, a normal thickness epiglottis

Epiglottitis usually begins as an inflammation and swelling between the base of the tongue and the epiglottis. This may cause the throat structures to push the epiglottis backward. With continued inflammation and swelling of the epiglottis, complete blockage of the airway may occur, leading to suffocation and death.

Causes 3) Robbins Basic Pathology by Vinay Kumar

  • H. influenzae

Symptoms 4) Emedicine

  • Lung involvement – trouble breathing (respiratory distress), drooling, leaning forward to breathe, taking rapid shallow breaths, “pulling in” of muscles in the neck or between the ribs with breathing (retractions), high-pitched whistling sound when breathing (stridor)

Diagnosis 5) Wikipedia

  • Lateral C-spine X-ray – thumbprint sign (or “thumb sign”) describes a swollen, enlarged epiglottis; usually with dilated hypopharynx and normal subglottic structures 
  • CT imaging – “halloween sign” describe a normal thickness epiglottis

Treatment 6)Emedicine7)Wikipedia

  • Cricothyrotomy – cutting the neck to insert a breathing tube directly into the windpipe 
  • Antibiotics – second- or third-generation cephalosporins, either alone or in combination with penicillin or ampicillin for streptococcal coverage

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