Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2017 Jun 18:2017:bcr2017219631.
doi: 10.1136/bcr-2017-219631.

Multipathogenic necrotising supraglottitis in an immunocompetent patient

Jacob Joseph Ahmed  1 , James Douglas Constable  1 , Tawakir Kamani  1 , Mriganka De  1
Affiliations
Case Reports

Multipathogenic necrotising supraglottitis in an immunocompetent patient

Jacob Joseph Ahmed et al. BMJ Case Rep. .

Abstract

Supraglottitis is a potentially life-threatening condition. It is now uncommon due to the Haemophilus influenzae type B vaccination and is more recently caused by Streptococcus pneumoniae, S. pyogenes, H. influenzae non-type B, H. parainfluenzae, Staphylococcus aureus and Pasteurella multocida Very rarely, it can cause necrotising supraglottitis/epiglottitis, and this has been reported in immunocompromised individuals. We present a unique case of multipathogenic supraglottitis causing laryngeal fibrinoid necrosis in an immunocompetent patient. During his admission, the patient was critically unwell and required surgical intervention and tracheostomy. However, he made a full recovery with no persisting morbidity. We believe that this was owed to the aggressive antimicrobial therapy, timely surgical management of the disease process and the patient’s immunocompetency.

Keywords: Ear nose and throat/otolaryngology; Infectious diseases; Otolaryngology / ENT.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Axial and sagittal views of the patient’s CT neck scan, depicting (a) the process at the level of the epiglottis, (b) the process at the level of the hyoid, (c) the process at the level of the vocal cords and (d) the severity and level of airway compromise.
Figure 2
Figure 2
Intraoperative views of the supraglottis, obtained via microlaryngoscopy.
Figure 3
Figure 3
Histology slides of left hemilaryngeal, debrided tissue. (a) Low-power light microscopy. (b) High-power light microscopy.
See this image and copyright information in PMC

References

    1. McGill TJ, Jones D. Non-malignant conditions of the paediatric larynx. Bath: Oxford University Press, 1998:p598.
    1. Senior BA, Radkowski D, MacArthur C, et al. . Changing patterns in pediatric supraglottitis: a multi-institutional review, 1980 to 1992. Laryngoscope 1994;104:1314–22. - PubMed
    1. Gorbach SL, Bartlett JG, Blacklow NR. Infectious disease. 3rd edn Taunton: Quebecor World, 2004:p460.
    1. Klcova J, Mathankumara S, Morar P, et al. . A rare case of necrotising epiglottitis. J Surg Case Rep 2011;2011:5 doi:10.1093/jscr/2011.2.5 - DOI - PMC - PubMed
    1. Kumar V, Abbas AK, Aster JC. Robbins Basic Pathology. Philadelphia: Elsevier, 2013:p11.

Publication types

MeSH terms