Acute epiglottitis

Case contributed by Matthew Hung

Presentation

50-year-old male with a history of uncontrolled diabetes mellitus presenting with fever, sore throat, dysphagia and odynophagia for 3 days.

Patient Data

Age: 50 years old
Gender: Male
CT

Markedly enlarged epiglottis with peripheral enhancement, partially obstructing the airway. There is inflammation and swelling of the aryepiglottic folds, obliteration of bilateral piriform sinuses (best seen on coronal images), and mild swelling of the vocal cords. The valleculae are completely obliterated due to severe swelling of the epiglottis.

Multiple lymph nodes of variable size are present, most prominent in level II bilaterally. 

Case Discussion

The patient was febrile on presentation to 38.1ºC, with elevated WBC count to 13.8. Flexible laryngoscopy revealed an erythematous and swollen epiglottis. The patient was taken to the OR emergently for awake tracheostomy. The patient improved on IV antibiotics and was discharged with augmentin. Rapid Group A Strep test was negative. Respiratory, throat and AFB cultures demonstrated no growth. 

 

This case was submitted with supervision and input from:

Soni C. Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center    

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Case information

rID: 54375
Case created: 6th Jul 2017
Last edited: 17th Jul 2017
System: Head & Neck
Inclusion in quiz mode: Included

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