Influenza A–Associated Epiglottitis and Compensatory Pursed Lip Breathing in an Infant

Abstract

The last 3 decades have seen a shift in the epidemiology of epiglottitis. Epiglottitis was once most commonly associated with Haemophilus influenzae type B. However, with the implementation of the H. influenzae type B vaccine in 1985, the incidence has drastically declined. There are now new emerging pathogens—bacteria, viruses, and fungi—causing epiglottitis. Here, we report the first case of epiglottitis secondary to influenza A in a former full-term, vaccinated infant who presented with cough, fever, stridor, pursed lip breathing, and progressive respiratory distress and eventual respiratory failure. This case highlights the presentation and clinical course of epiglottitis and describes a rare clinical feature, pursed lip breathing, in an infant.

Respiratory Virus Co-infection in Acute Respiratory Infections in Children

“…Although vaccination against influenza decreases the risk of infection, now with less vaccination we are witnessing less herd immunity and those more vulnerable are becoming severely ill [19]. In my practice, I've witnessed a 2-month-old infant-too young for the Influenza vaccine and caregivers opted out of the influenza vaccination for themselves-develop respiratory failure requiring endotracheal intubation due to influenza A epiglottitis [20].…”

The modern view on the epiglottitis treatment

“…Вірусні інфекції надзвичайно рідко викликають абсцес надгортанника. При цьому є відомості про вірус грипу типу A [25], вірус грипу типу B, вірус простого герпесу 1-го і 2-го типу, вірус парагрипу типу 3, вірус Епштейна -Барр [31], вірус імунодефіциту людини, SARS-CoV-2 [10-12, 26, 32]. Грибкові інфекції як причина абсцесу надгортанника зустрічаються не часто і виникають у пацієнтів із пригніченим імунітетом: різновиди Candida і Histoplasma capsulatum [1].…”