Epiglottitis Differential Diagnoses

  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Pamela L Dyne, MD   more...
 
Updated: Jul 14, 2011
 
 

Diagnostic Considerations

Clinician familiarity with epiglottitis has lessened in the post-Hib vaccination era, which may lead to less acumen in the diagnosis of this potentially deadly disorder. Efforts toward continued diligence in promptly making this diagnosis are therefore warranted, particularly in the adult patient, for whom epiglottitis has many possible causes other than Haemophilus influenzae type b.[10]

Depending on the clinical setting, it may be risky to send the patient off-unit for radiologic studies, and direct visualization of the epiglottis may precipitate respiratory obstruction. Rapid diagnosis may depend on the examination and those tests that can be performed quickly at the bedside.

Other conditions to consider in the evaluation of acute epiglottitis include the following:

  • Acute angioedema
  • Airway obstruction
  • Bacterial laryngotracheobronchitis
  • Caustic ingestion
  • Thermal injury from liquids or hot air (burns)
  • Foreign body aspiration
  • Laryngeal diphtheria
  • Laryngitis
  • Laryngotracheal bronchopneumonitis
  • Peritonsillar abscess
  • Retropharyngeal abscess
  • Sepsis

See also Pediatric Epiglottitis and Emergent Management of Pediatric Epiglottitis.

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Sandra G Gompf, MD, FACP, FIDSA  Associate Professor of Infectious Diseases and International Medicine, University of South Florida College of Medicine; Chief, Infectious Diseases Section, Director, Occupational Health and Infection Control Programs, James A Haley Veterans Hospital

Sandra G Gompf, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Jeffrey Glenn Bowman, MD, MS  Consulting Staff, Highfield MRI

Disclosure: Nothing to disclose.

Specialty Editor Board

Debra Slapper, MD  Consulting Staff, Department of Emergency Medicine, St Anthony's Hospital

Debra Slapper, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Chief Editor

Pamela L Dyne, MD  Professor of Clinical Medicine/Emergency Medicine, University of California, Los Angeles, David Geffen School of Medicine; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center

Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References

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  2. Kavanagh KR, Batti JS. Traumatic epiglottitis after foreign body ingestion. Int J Pediatr Otorhinolaryngol. Jun 2008;72(6):901-3. [Medline].

  3. Wallenborn PA 3rd, Postma DS. Radiation recall supraglottitis. A hazard in head and neck chemotherapy. Arch Otolaryngol. Sep 1984;110(9):614-7. [Medline].

  4. Berg S, Trollfors B, Nylén O, Hugosson S, Prellner K, Carenfelt C. Incidence, aetiology, and prognosis of acute epiglottitis in children and adults in Sweden. Scand J Infect Dis. 1996;28(3):261-4. [Medline].

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  18. Kim SG, Lee JH, Park DJ, et al. Efficacy of spinal needle aspiration for epiglottic abscess in 90 patients with acute epiglottitis. Acta Otolaryngol. Jul 2009;129(7):760-7. [Medline].

  19. Ito K, Chitose H, Koganemaru M. Four cases of acute epiglottitis with a peritonsillar abscess. Auris Nasus Larynx. Apr 2011;38(2):284-8. [Medline].

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Soft-tissue lateral neck radiograph reveals edema of epiglottis consistent with acute epiglottitis.
 
 
 
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