IS Case 261: Epiglottitis

Meena Moorthy, MD, MBA

Imaging Sciences URMC 2009
Publication Date: 2009-06-26

History

A 54-year-old female presents with fever, sore throat, and difficulty swallowing.

Epiglottitis; with "thumb print" sign.

Epiglottitis is a rapidly developing inflammation of the epiglottis and adjacent tissues, usually due to a bacterial infection, that can cause life-threatening airway obstruction. Although it is generally thought of as a pediatric disease, it can occur in adults as well.

Findings on lateral neck radiographs are frequently diagnostic. A single, lateral, upright view of the neck in extension, is usually adequate. Swelling of the epiglottis is easily seen on this view; the epiglottis will appear thickened, resembling a "thumbprint". In adults, the epiglottis is generally considered enlarged if it is greater than 8 mm in AP diameter.

Treatment consists of airway protection, and appropriate antibiotic therapy.