Thermal epiglottitis: Acute airway obstruction caused by ingestion of hot food

Inaguma, Yosuke; Matsui, Satoshi; Kusumoto, M; Kurosawa, Hiroshi; Tanaka, Ryojiro

doi:10.1111/ped.13948

Cited by 6 publications

(2 citation statements)

References 4 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Presently, the causes of epiglottitis are predominantly non-infectious. Traumatic supraglottitis can result from various types of airway injuries, including mechanical, thermal, or chemical ( 7 , 8 ). The airways in children are comparatively narrower than those in adults ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

The emergence of non-infectious epiglottitis after the era of Hemophilus influenza type B universal vaccination: two case reports and literature review

Safia,

Shehadeh,

Merchavy

2024

Front. Pediatr.

View full text Add to dashboard Cite

ObjectiveFollowing the global dissemination of vaccination protocols for Hemophilus influenza type B, the occurrence rate and burden of infectious epiglottitis decreased rapidly and substantially. However, this gave space to the rise of non-infectious causes, with children being more vulnerable than adults. This report aims to divert the clinician's attention to the existence of other non-infectious causes of epiglottitis, all of which require careful attention and timely management for favorable clinical outcomes.Case summaryTwo cases with positive vaccination history were encountered in our practice. The first case was a 4-year-old girl, presenting with stridor drooling, and dyspnea, later complication by apnea. The fiberoptic exam revealed severe epiglottitic swelling with near-complete injury of the vocal cords with a circumferential burn. She did not respond to racemic epinephrine, and a tracheostomy was done. She was discharged after 6 days with minimal soft palate swelling. The second case was a 2-year-old boy presenting after exposure to an alkaline solution. The case exhibited similar symptoms but with white plaques and edema of the soft palate. The fiberoptic exam showed swelling and erythema of the supraglottic structures with partial obstruction. Although the blood culture was negative, he was intubated and given four intravenous boluses of dexamethasone and penicillin. On the fifth day, the patient was discharged after a normal fiberoptic examination.DiscussionThese cases highlight a crucial shift in the etiology of epiglottitis post widespread Hemophilus influenza type B vaccination, underscoring the emergence of non-infectious causes, particularly in children. The two cases presented, both with vaccination histories, demonstrate diverse non-infectious triggers leading to severe epiglottitis. The first case, involving thermal injury, and the second, chemical exposure, both necessitated intensive interventions, including tracheostomy and intubation. These instances emphasize the need for heightened clinical vigilance for non-infectious epiglottitis, demanding prompt recognition and management to ensure positive outcomes. This shift in etiology calls for a reevaluation of traditional diagnostic and therapeutic approaches to pediatric epiglottitis.

show abstract

Section: Discussionmentioning

confidence: 99%

The emergence of non-infectious epiglottitis after the era of Hemophilus influenza type B universal vaccination: two case reports and literature review

Safia,

Shehadeh,

Merchavy

2024

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…Серед неінфекційних причин фігурують такі стани. Місцеві травми дихальних шляхів, такі як: термічна травма від застосування гарячих напоїв або їжі [5], електронних сигарет [1] або вдихання нагрітих предметів під час вживання заборонених наркотиків, таких як крек; пряма травма надгортанника; проковтування або вдихання їдких речовин. Лімфопроліферативне захворювання або реакція «трансплантат проти господаря» після трансплантації кісткового мозку або паренхіматозних органів.…”

Section: клінічний випадокunclassified

Peculiarities of patients with epiglottis abscess management at all stages of medical care

Kononov,

Pogorelov,

Nikolayenko

et al. 2023

View full text Add to dashboard Cite

An epiglottis abscess is usually the final stage of epiglottis (epiglottitis) and surrounding tissues inflammation and can progress to life-threatening airway obstruction without treatment. The etiology of the disease can be infectious or non-infectious nature. Both with infectious and non-infectious etiology, swelling of the epiglottis occurs as a result of the accumulation of inflammatory cells in the space between the layer of squamous epithelium and the epiglottis cartilage. The lingual surface of the epiglottis and peri-epiglottis tissues have a large network of lymphatic and blood vessels, which promotes the spread of infection and the subsequent inflammatory reaction. Once the infection begins, the swelling rapidly progresses, involving the entire epiglottis of the larynx (including the epiglottis folds and the epiglottis cartilages). Clinical signs of epiglottitis vary depending on age, severity, and etiology. Purpose - is to describe a clinical case of successful care for a child with an epiglottis abscess and the optimal route of the patient at all levels of medical care. Clinical case. An ambulance delivered a patient G., born in 2005 (17 years old), to the emergency otorhinolaryngology department of the Kyiv City Children’s Clinical Hospital 1. During the examination in the emergency department with indirect laryngoscopy the diagnosis was established: abscess of the epiglottis. An epiglottis abscess was urgently dissected under endotracheal anesthesia. The difficulty of diagnosing an epiglottis abscess was that visualization of the larynx is possible only with the use of instrumental examination methods, such as indirect laryngoscopy. This method is not within the competence of a family doctor. Accordingly, the family doctor, within the limits of his competencies, appropriately used the ISPS-2 international classification, section «R» - respiratory system and code - «76» and made a diagnosis of acute tonsillitis, thereby assuming the infection etiology of the disease. The family doctor, taking into account the severity of the condition, according to the patient’s itinerary, issued a referral for urgent hospitalization, according to the child's moderate condition. In our opinion, the main reason for achieving a good clinical result was an interdisciplinary approach: a combination of correctly performed diagnostics and timely surgical intervention. We hope that this clinical example, which demonstrates the features of interdisciplinary interaction between specialists, will improve the quality of medical care for patients with epiglottis abscess. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

show abstract