Wednesday, July 30, 2008

Acute Epiglottitis

Hmm.. pilot project... want to see how this turns out... please comment on how I can improve on this~

Causative agent:

- Haemophilus Influenza B (Hib) [most common]
- Streptococcus pneumoniae
- Klebsiella pneumoniae
- Staphylococcus aureus
- Candida albicans
- Haemophilus parainfluenzae
- Neisseria meningtidis
- etc

High incidence group:

- Typically 5 years and below

Signs & symptoms:

- high fever
- severe airflow obstruction
- inspiratory stridor
- drooling
- difficulty swallowing
- difficulty breathing
- cyanosis
- chills
- sore throat
- muffled dysphonia
- cervical adenopathy

Investigations:

- Laryngoscopy - shows a red and swollen epiglottis
- Blood or throat culture - show Haemophilus influenza B or other bacteria
- CBC (Complete Blood Count) - high number of white blood cells
- Neck X-rays - swollen epiglottis

Treatment:

- Endotracheal intubation
- IV Cloramphenicol, Ceftazidime
- Corticosteroids to reduce swelling of throat

Complications:

- Death by asphyxia may occur if airway is blocked, onset is rapid hence is considered a medical emergency

Others:

- Do NOT attempt to inspect the throat using a tongue depressor or such similar instruments unless facilities for endotracheal intubation or tracheostomy immediately available as this may precipitate spasms in the throat causing airway blockage
- Vaccination for Hib is available