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Epiglottitis, Pediatric

Epiglottitis, Pediatric is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Inflammation of the epiglottis and surrounding supraglottic region, which is potentially life threatening due to progressive airwayobstruction
  • Children are at greater risk of upper airway obstruction owing to:
    • Decreased cross-sectional area of the upper airway (resistance is proportional to the inverse of the radius to the 4th power)
    • Loose attachment of mucosal surface and increased vascularity of mucosa allows for edema
    • Dynamic collapse of the airway
  • A precipitous decline in the incidence of childhood epiglottitis since the introduction of the Haemophilus influenzae vaccination has occurred, although vaccine failure may result in rare cases among children who have been immunized
  • In the post-Hib vaccine era, the mean age for this disease has increased, and it is now more commonly seen in adolescents and adults than in toddlers or young school-aged children.
  • May occur throughout the year

ALERT
All patients with suspected epiglottitis require intensive monitoring and intervention. Rapid progression of airway obstruction may occur.

Etiology

  • Infection:
    • H. influenzae type B
    • Streptococcus pneumoniae
    • Group A β-hemolytic
    • Streptococcus
    • Staphylococcus aureus
    • Viruses
    • Less common infections include Klebsiella, Pseudomonas, Candida
  • Caustic
  • Thermal
  • Traumatic
  • Post-transplant lymphoproliferative disorder
  • Hereditary angioedema

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Citation

Rosen, Peter, et al., editors. "Epiglottitis, Pediatric." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307127/all/Epiglottitis__Pediatric.
Epiglottitis, Pediatric. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307127/all/Epiglottitis__Pediatric. Accessed April 23, 2019.
Epiglottitis, Pediatric. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307127/all/Epiglottitis__Pediatric
Epiglottitis, Pediatric [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307127/all/Epiglottitis__Pediatric.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Epiglottitis, Pediatric ID - 307127 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307127/all/Epiglottitis__Pediatric PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -