Acute Epiglottitis

Another sore throat

Step 1: View clinicals

A 46 year old man presents with throat discomfort and pain upon swallowing since last night. These symptoms rapidly worsened over time, such he now feels as if his throat is "closing up". The discomfort is worse on lying down. He also feels weak and ill. His medical history is unremarkable, while he has smoked a total of 20 pack years.

Step 2: Order all relevant investigations

Lateral X-ray neck (soft tissue view)

The lateral soft-tissue x-ray of the neck is positive for the "thumb sign".

Full Blood Count

WBC/DC: 10,000/ mm3 N: 82% L: 18% Hb: 13 g/dl Plt: 225,000/mm3

Blood cultures

The culture reports will be available in 3 days. The gram stain is negative.

Fibreoptic laryngoscopy

A red, swollen epiglottis is visualized.

Step 3: Select appropriate management

Nil orally
Intubation stat
IV Antibiotics

Score: ★★☆