ear, nose, and throat disorders
Epiglottitis
Key Points
The incidence of epiglottitis has decreased significantly, particularly in children, because of widespread vaccination against the most common cause,Haemophilus influenzaetype B. Stridor, as well as sore throat with a normal-appearing pharynx, are important clues. Examination of the pharynx or larynx in children with epiglottitis and stridor may precipitate complete airway obstruction. If the diagnosis is suspected, do flexible fiberoptic laryngoscopy in the operating room; reserve imaging studies for cases with very low suspicion. Children typically should have their airway secured by tracheal intubation; adults often can be observed for signs of airway compromise. Give a beta-lactamase–resistant antibiotic, such asceftriaxone. 