1. Morning Report
Chris Dado
5-2-14

4. Supraglottitis/Epiglottitis
• Acute, rapidly progressing form of cellulitis of
the epiglottis and surrounding structures
• Can result in complete airway obstruct
• Most common bacterial pathogens
– Hib (more in children)
– GAS
– S. pneumoniae, H. parainfluezae, S. aureus
(including MRSA)

5. Supraglottitis/Epiglottitis
Children v. Adults
• Presents more acutely in pediatric population,
usually present within 24 hours with high
fevers, sore throat, tachycardia, and drooling
while leaning forward
• Adolescents and adults: milder, severe sore
throat accompanied by dyspnea, drooling,
and stridor.

6. Physical Exam
• Mod-severe respiratory distress
• inspiratory stridor
• retractions of chest wall
• Oropharyngeal exam: underwhelming

7. Diagnosis
• Often made on clinical grounds
• Laryngoscopy: “cherry red” epiglottis
• Neck radiographs: Thumbprint sign
• Labs: moderate leukocytosis with PMNs, BCX
often positive

9. Treatment
• Secure airway- usually more conservative with
adults
• Iv antibiotics- Hib
• Amp/sulbactam, cefuroxime, cefotaxime, or
CTX
• Clinda or TMP-SMX for pt with allergies
• 7-10 days of therapy

10. prophylaxis
• If unvaccinated child under 4 exposed in
household to Hib- 4 days of rifampin