🎙️ FREE MSRA PODCAST – Epiglottitis
🧠 A focused revision audio on this ENT emergency that’s small in size but massive in significance. Let’s break down what matters — and what saves lives.
🔍 What is Epiglottitis?
Severe, potentially life-threatening inflammation of the epiglottis 🛑
➡️ Risk of airway obstruction due to swelling
💡 Supraglottitis = inflammation spreading above vocal cords
🧫 Causes
• 📉 Historically: Haemophilus influenzae type B (Hib)
• 📈 Now: Streptococcus pneumoniae, Staph aureus, Hib in adults
• 🧬 Immunocompromised? Think Pseudomonas & Candida
• 🦠 Viruses: e.g. HSV (esp. with bacterial superinfection)
• ❗ Non-infectious: trauma, sarcoidosis, polyangiitis, chemo/radiation
💡 It’s not just Hib anymore!
⚠️ Red Flags & Classic Features
• Stridor (noisy breathing) 🚨
• Sudden high fever, drooling, dysphagia
• Muffled “hot potato” voice
• Tripod posture (leaning forward, mouth open)
💡 Mnemonic: 3 D’s – Drooling, Dysphagia, Distress
🧍♂️ Risk Factors
• Children aged 2–6 (pre-vaccine)
• Adults: more cases now, esp. immunocompromised
• Living in crowded settings
• Lack of Hib vaccination
📊 Epidemiology (UK)
• Now rare in kids due to routine Hib vaccine
• ⬆️ Increased prevalence in adults (esp. 40s–50s, males)
• ~1–4 cases per 100,000
💉 Prevention = vaccination success story
🩺 Diagnosis
✅ Clinical suspicion first — don’t delay
• Direct visualisation = gold standard (cherry red epiglottis)
• Lateral neck X-ray → 📸 Thumbprint sign
• Bloods, cultures, and CT/MRI only after airway is safe
🚨 NEVER delay securing the airway for investigations!
💊 Management
👃 Airway first — BVM, intubation, or surgical airway
❌ Supraglottic devices (LMAs) = ineffective
💉 IV Ceftriaxone (or Cefotaxime), 7–10 days
💊 Add MRSA cover if needed
🧘♀️ Comfort measures, esp. for kids
🚨 Emergency ENT referral if stridor or distress
📈 Prognosis
👍 Excellent with prompt management
📉 Only ~15% need intubation with early diagnosis
⚠️ Untreated → rapid deterioration, airway compromise, death
💉 Vaccine = massive reduction in childhood cases
🔥 Complications
• Respiratory failure 🫁
• Pneumonia, sepsis, abscesses (25% in some cases!)
• Meningitis, pneumothorax, even pneumomediastinitis
📚 Useful Resources for Epiglottitis (MSRA)
📝 Revision Notes:
https://www.passthemsra.com/topic/epiglottitis-revision-notes/
🧠 Flashcards:
https://www.passthemsra.com/topic/epiglottitis-flashcards/
💬 Accordion Q&A Notes:
https://www.passthemsra.com/topic/epiglottitis-accordion-qa-notes/
🚀 Rapid Quiz:
https://www.passthemsra.com/topic/epiglottitis-rapid-quiz/
🎯 Quiz:
https://www.passthemsra.com/quizzes/epiglottitis/
🎓 Full ENT Course:
https://www.passthemsra.com/courses/ent-for-the-msra/
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