Case report: Epiglottitis in the setting of COVID-19

Smith, Connor; Mobarakai, Olivia; Sahra, Syeda; Twito, Joshua; Mobarakai, Neville

doi:10.1016/j.idcr.2021.e01116

Cited by 14 publications

(18 citation statements)

References 7 publications

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“…Only one patient presented with swelling of an arytenoid region. However, in the literature search we identified seven cases of acute epiglottitis with concomitant COVID‐19 infection [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ], so this diagnosis should be considered and promptly excluded, especially if a patient is presenting with a typical clinical triad.…”

Section: Discussionmentioning

confidence: 99%

Acute odynophagia: A new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden

et al. 2022

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Objective The objective of this study is to present a novel clinical manifestation of infection with the Omicron variant of the SARS‐CoV‐2 virus affecting mainly young, vaccinated, and healthy adults. We describe a new group of COVID‐19 patients seeking emergency care with symptoms similar to the life‐threatening condition epiglottitis. Here, we present a case series and discuss management. Methods We performed a retrospective single‐center case study of patients diagnosed with COVID‐19 who were referred to the Ear, Nose, and Throat Emergency Department (ENT ED) between January 1 and January 23, 2022 with clinical symptoms such as acute odynophagia, severe sore throat, and fever. Ethical approval was obtained from the Swedish Ethical Review Authority (2020‐02579). Informed consent was obtained from all patients included in the study. Results Twenty patients meeting inclusion criteria were identified. Fifteen patients were fully vaccinated against COVID‐19. Four patients needed a short hospitalization for their symptoms. The most common diagnoses were COVID‐19‐associated acute viral laryngotracheitis and/or viral pharyngitis. Six patients presented with signs of secondary bacterial infection and were put on antibiotics. Conclusion Previous variants of SARS‐CoV‐2 infection affected predominantly the lower respiratory tract and were associated with loss of smell and taste in many patients. The Omicron variant seems to affect predominantly the upper airways and cause acute laryngitis without olfactory dysfunction. In some patients, the clinical manifestation is similar to the symptoms of epiglottitis. In such a case, a prompt examination of the larynx is the gold standard to exclude inflammatory edema in the upper airways. None of the patients described in this study developed epiglottitis. In this study, we discuss the management of acute odynophagia in COVID‐19 patients.

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Section: Discussionmentioning

confidence: 99%

Acute odynophagia: A new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden

et al. 2022

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“…Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a rapidly progressing respiratory disease that also affects the upper aerodigestive tract via angiotensin-converting enzyme 2 or transmembrane protease/serine subfamily member 2 receptors [ 1 , 2 ], causing a sore throat and odynophagia. There are reports of COVID-19-induced acute laryngitis requiring emergency treatment, indicated by acute epiglottitis in adults and croup in infancy [3] , [4] , [5] , [6] , [7] , [8] , [9] . Frequently, this requires urgent airway management, which generates aerosols and increases the risk of spreading the infection.…”

Section: Introductionmentioning

confidence: 99%

“…There are reports of COVID-19-induced acute laryngitis requiring emergency treatment, indicated by acute epiglottitis in adults and croup in infancy [3][4][5][6][7][8][9]. Frequently, this requires urgent airway management, which generates aerosols and increases the risk of spreading the infection.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 presenting as acute epiglottitis: A case report and literature review

Iwamoto¹,

Satõ²,

Hoshi

et al. 2023

Auris Nasus Larynx

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Coronavirus disease 2019 (COVID-19) occasionally causes acute laryngitis, requiring emergency treatment. Understanding the characteristic laryngeal findings can help diagnose COVID-19 earlier, prevent worsening infection, and properly manage airway obstruction. Herein, we report the case of a 44-year-old male with acute epiglottitis likely caused by COVID-19. On presentation, chest computed tomography (CT) showed no signs of pneumonia. However, the larynx had extensive necrotic-like erosive lesions resembling those of tuberculous laryngitis. COVID-19 was diagnosed by reverse-transcription polymerase chain reaction, and secondary bacterial superinfections were suspected after blood testing. The symptoms improved after administration of antibiotics (sulbactam sodium/ampicillin sodium), steroids (dexamethasone), and favipiravir. The patient developed a high fever on the sixth day of hospitalization, and pneumonia was identified on CT. Various culture tests, including tuberculosis, were negative. Thus, remdesivir was administered for COVID-19-induced pneumonia. The patient gradually recovered, was transferred to another hospital, and was discharged on the 35th day of hospitalization. Six previous case reports of COVID-19-induced acute epiglottitis suggested that acute epiglottitis preceded the onset of pneumonia. The laryngeal findings from this report may be useful for diagnosing COVID-19 that does not cause pneumonia and for bringing attention to pneumonia after a COVID-19 diagnosis.

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“…Epiglottitis has become less prevalent amongst adult patients over time due to widespread vaccination against Haemophilus influenzae type b (Hib) --the most common isolated pathogen in cases of epiglottitis. However, the proportion of epiglottitis cases caused by other pathogens has increased over time [5].…”

Section: Introductionmentioning

confidence: 99%

“…During the past three years, there have been multiple reported cases of adult epiglottitis associated with Coronavirus disease 2019 (COVID-19) [5][6][7][8][9][10]. COVID-19 may present with a wide range of symptoms, including respiratory any further procedures as indicated including but not limited to tracheostomy or abscess drainage.…”

Section: Introductionmentioning

confidence: 99%

Acute Epiglottitis in a Patient with COVID-19 and C1 Esterase Deficiency: A Case Report

Sampreeti¹,

S²,

C³

et al. 2022

J Clin Anesth Pain Manag

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Coronavirus disease 2019 (COVID-19) has been associated with the rare, yet potentially fatal, condition known as epiglottitis. Epiglottitis has the potential to lead to complete airway obstruction, and often constitutes emergent management. Here, we describe a case of acute epiglottitis in a 19-year-old man infected with COVID-19 with a past history of angioedema. We discuss the management of this emergent condition, as well as the differential diagnosis and various management complexities inherent in patients presenting with epiglottitis in this new age of the COVID-19 pandemic.

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Case report: Epiglottitis in the setting of COVID-19

Cited by 14 publications

References 7 publications

Acute odynophagia: A new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden

Acute odynophagia: A new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden

COVID-19 presenting as acute epiglottitis: A case report and literature review

Acute Epiglottitis in a Patient with COVID-19 and C1 Esterase Deficiency: A Case Report

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