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Acute Epiglottits (ppt)
Acute epiglottitis is an inflammatory condition affecting supraglottic structures, often caused by infections such as Haemophilus influenzae type b, especially in children. Symptoms include severe sore throat, difficulty swallowing, and respiratory distress, with a risk of airway obstruction. Management requires hospitalization, use of antibiotics and steroids, and in severe cases, intubation or tracheostomy; while the prognosis is generally good with timely treatment, the risk of sudden airway compromise is significant.
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Describes the epiglottis structure, its attachment, and relevance in the airway anatomy.
Defines acute epiglottitis; highlights inflammation in supraglottic structures and risks of airway obstruction.
Identifies Haemophilus influenzae as a common cause in children, with a lower prevalence in adults.
Lists symptoms like odynophagia, stridor, and drooling indicative of acute epiglottitis.
Presents physical signs including fever and stridor indicating the presence of inflammation.
Outlines examination methods and concerns regarding airway obstruction during indirect laryngoscopy.
Describes imaging techniques like X-ray and CT scans showing signs of epiglottitis and its complications.
Lists infectious and non-infectious diseases to differentiate from acute epiglottitis.
Discusses potential complications including infections spreading to inner ear, brain, and lungs.
Describes hospitalization, antibiotics, hydration, and potential need for intubation in severe cases.
Discusses prognosis of acute epiglottitis in adults, risks of airway obstruction, and mortality.
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Acute Epiglottits (ppt)
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- 2. • Leaf like,yellow, elastic cartilage forming anterior wall of laryngeal inlet. • Attached to body of hyoid bone by hyoepiglottic ligament (dividing it into supra hyoid & infra hyoid epiglottis). • Anterior surface of epiglottis is separated from thyrohyoid membrane & upper part of thyroid cartilage by a potential space filled with fat— the pre- epiglottic space . • Space can be invaded in carcinoma of supraglottic larynx or base of tongue. ANATOMY
- 3. Supraglottic structures, egepiglottis, aryepiglottic folds and arytenoids.
- 4. Definition: Acute inflammatory condition confinedto supraglottic structures:- -epiglottis -aryepiglottic folds -arytenoids There is marked oedema of these structures which may obstruct the airway. ACUTE EPIGLOTTITIS (SYN. SUPRAGLOTTIC LARYNGITIS)
- 5. Classically described as a Haemophilus influenzaetype B bacterial infection of the epiglottis in children. In adults only 20% of epiglottitis is caused by Haemophilus influenzae. Figure 3.0: Organisms that can cause acute epiglottitis in adults. AETIOLOGY:
- 6. • Odynophagia • Inabilityto swallow secretions • Sore throat • Muffled voice-“hot potato voice” • Hoarseness • Cough • Dyspnoea • Rising sun sign- “angry red epiglottis” • Respiratory distress SYMPTOMS
- 7. • Fever (>37.2°C) • Tachycardia (100 bpm) • Pharyngitis • Swelling of the epiglottis • Cervical lymph nodes • Swelling of supraglottic tissue • Inspiratory stridor • Drooling/inability to handle secretion SIGNS
- 8. • Depressing thetongue with a tongue depressor may show red & swollen epiglottis. • Indirect laryngoscopy may show oedema & congestion of supraglottic structures. This examination is avoided for fear of precipitating complete obstruction (better done in OT where facilities for intubation are available). EXAMINATION
- 9. • Lateral softtissue X-ray of neck may show swollen epiglottis (thumb sign) • CT & MRI :- Helpful to evaluate the complications of this disorder ,such as : -abscess formation -thickening of the epiglottis, -obliteration of the pre-epiglottic fat ;& -thickening of the subcutaneous tissue and muscles are common radiological findings in epiglottic abscess
- 11. A lateral soft-tissueradiograph of the neck showed a “thumb sign” (arrow). This radiographic sign is a manifestation of an enlarged and edematous epiglottis, and it suggests a diagnosis of acute infectious epiglottitis.
- 12. DIFFERENTIAL DIAGNOSIS INFECTIOUS DISEASESNON-INFECTIOUS DISEASES • Mononucleosis • Diphtheria • Pertussis • Croup • Tonsillitis • Subglottic laryngitis • Allergic reactions • Angioneurotic oedema • Foreign body aspiration • Reflex laryngospasm • Laryngeal trauma • Tumours • Hydrocarbon aspiration • SLE • Inhalation of toxic fumes or superheated steam
- 13. In some cases,an infection can spread from the epiglottis to nearby parts of the body, including the: • Inner ear (otitis media) • Brain (meningitis) • Heart lining (pericarditis) • Lungs (pneumonia) • Cervical adenitis • Epiglottic abscess COMPLICATIONS
- 14. 1. Hospitalisation -essentialbecause of the danger of respiratory obstruction 2. Antibiotics -Ampicillin -Third generation cephalosporin (i) effective against H.influenzae (ii) given by parenteral route (i.m/i.v) 3. Steroids -hydrocortisone/dexamethasone (i.m/i.v) 4. Adequate hydration -parenteral fluids 5. Humidification and oxygen 6. Intubation or tracheostomy -respiratory obstruction TREATMENT
- 15. Algorithm for management ofepiglottitis
- 16. Source: Acute AdultSupraglottitis: Current Management and Treatment Mohannad Al-Qudah, MD, FAAOHNS, Shetty, S. MD, M. Alomari, MD, Maen Alqdah, FRCPC, FCCP South Med J. 2010;103(8):800-804.-Medscape-
- 17. 1.The prognosis inadults with acute epiglottitis is good with appropriate and timely treatment. 2.Most patients can be extubated within several days. 3.However, unrecognised epiglottitis may rapidly lead to airway compromise and resultant death. 4.In spite of acute epiglottitis generally having a good prognosis, the risk of death for persons is high due to sudden airway obstruction and difficulty intubating patients with extensive swelling of supraglottic structures. 5.Reported cases do include sudden fatal cardiorespiratory arrest occurring in patients without previous evidence of respiratory obstruction while in an intensive care unit (ICU) setting, emphasising the importance of providing close monitoring and adequate airway protection in these patients. The adult mortality rate is around 7%. PROGNOSIS