Epiglottitis

Findings

Severe thickening of the epiglottis and aryepiglottic folds


Diagnosis: Epiglottitis


Key points

Epiglottitis is acute swelling of the epiglottis and the surrounding soft tissues including the arytenoids and the aryepiglottic folds. The spectrum of epiglottitis has significantly changed over the past 2 decades with the introduction of the Hib vaccine in 1985. Prior to 1985, the disease primarily occurred in children aged 2-7. Other bacteria (Staph and Strep), trauma and thermal injury can cause epiglottitis.
Radiology plays an important role in confirming epiglottitis but in any patient with the possible diagnosis, a bedside radiograph should be obtained and consultation with ENT or Anesthesia should be done to insure proper airway management.
Radiographic signs: the classic finding is the thumb sign which is a thickened epiglottis protruding from the anterior wall of the hypopharynx. It is important to remember that a negative radiograph does not rule out epiglottitis, especially in the early stages of presentation.