Adult epiglottitis: an under-recognized, life-threatening condition

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Presentation transcript:

Adult epiglottitis: an under-recognized, life-threatening condition W.A. Ames, V.M.M. Ward, R.M.D. Tranter, M. Street British Journal of Anaesthesia Volume 85, Issue 5, Pages 795-797 (November 2000) DOI: 10.1093/bja/85.5.795 Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 1 Lateral soft tissue radiograph demonstrating the ‘thumb print’ sign (E). The ‘vallecula’ sign (V) can be determined by identifying the base of tongue (B) and tracing it inferiorly to the hyoid bone (B). If there is no pocket of air extending almost to the hyoid bone and roughly parallel to the pharyngotracheal air column, then the diagnosis of epiglottitis is confirmed. Laryngeal inlet is noted (L). British Journal of Anaesthesia 2000 85, 795-797DOI: (10.1093/bja/85.5.795) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 2 Sagittal MRI of case 1. The prominent swollen epiglottis (E) is clearly visible above the laryngeal inlet (L). The tracheostomy (T) is also noted. British Journal of Anaesthesia 2000 85, 795-797DOI: (10.1093/bja/85.5.795) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 3 Coronal MRI of case 1. Again the enlarged epiglottis (E) can be seen above the laryngeal inlet (L). British Journal of Anaesthesia 2000 85, 795-797DOI: (10.1093/bja/85.5.795) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 4 Fibreoptic nasendoscopy view in case 1. Unlike the classic cherry red epiglottis in children, adult epiglottitis is characterized by diffuse inflammation of aryepiglottic structures. Both the epiglottis (E) and the arytenoids (A) are clearly inflammed. The laryngeal inlet (L) is noted. British Journal of Anaesthesia 2000 85, 795-797DOI: (10.1093/bja/85.5.795) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions