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Adult Epiglottitis

Acute supraglottic inflammation threatening the adult airway

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our KBB (Kulak Burun Boğaz) department. Book Appointment →

What is Adult Epiglottitis?

Adult epiglottitis (supraglottitis) is acute inflammation of the epiglottis and surrounding supraglottic structures including aryepiglottic folds, arytenoids and false vocal cords. Although less common than the pediatric form since Hib vaccination, adult cases now predominate and result from bacterial infection (Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus) or thermal/caustic injury.

Mortality in adults is 1 to 7 percent and rises sharply with airway obstruction. Lateral soft tissue neck radiograph reveals the classic thumbprint sign, while flexible nasolaryngoscopy in a controlled setting confirms the diagnosis. Aggressive airway management remains the cornerstone of care.

Symptoms

Severe sore throat disproportionate to pharyngeal findings
Painful swallowing (odynophagia)
Drooling and inability to handle secretions
Muffled hot-potato voice
Inspiratory stridor
Tripod positioning leaning forward
Tachycardia and toxic appearance
High fever and rapid clinical deterioration

Risk Factors

Unvaccinated against Haemophilus influenzae type b
Diabetes mellitus and immunosuppression
Recent upper respiratory infection
Chemotherapy or HIV infection
Thermal injury (hot beverages, steam)
Caustic ingestion or smoke inhalation
Pharyngeal trauma
Crack cocaine inhalation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe throat pain with drooling (urgent)
  • Stridor or breathing difficulty (emergency)
  • Muffled voice with rapid worsening
  • Inability to swallow saliva
  • Tripod or sniffing position to breathe
  • Toxic appearance with high fever
  • Throat pain after thermal or caustic exposure

Treatment Methods

01
Avoid pharyngeal examination that may precipitate complete obstruction
02
Awake fiberoptic intubation in operating room with surgical airway preparation
03
Empiric IV ceftriaxone or ampicillin-sulbactam
04
Vancomycin added if MRSA suspected
05
IV dexamethasone to reduce supraglottic edema
06
ICU monitoring throughout the inflammatory phase
07
Fluid resuscitation and supportive care
08
Surgical drainage if epiglottic abscess identified on imaging
09
Otolaryngology, anesthesiology and emergency medicine team coordination

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About KBB (Kulak Burun Boğaz) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.