Presentation
Sore throat and hoarseness of voice for 2 days.
Patient Data
Lateral scout view of the soft tissues of the neck demonstrates a swollen epiglottis giving the characteristic "thumb" appearance. CT of the soft tissues of the neck displays marked thickening of the supraglottic airway including the epiglottis and aryepiglottic folds. There are foci of gas within the epiglottis due to emphysematous infection.
Case Discussion
This case shows the classic appearance of emphysematous epiglottitis in an adult with marked thickening of the supraglottic larynx including the epiglottis and aryepiglottic folds. The presence of gas is less common though suggests a more severe infection. In children, the infection classically occurs in unvaccinated children due to haemophilus influenzae type B. However, in adults, the infection is more variable with multiple possible pathogens including streptococcus, staph. aureus, and haemophilus influenzae.
In children, there is greater concern for airway compromise given the naturally smaller airways.
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