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Case Reports
. 2018 Dec 22;18(1):203.
doi: 10.1186/s12871-018-0665-7.

Beware of thermal epiglottis! A case report describing 'teapot syndrome'

V Verhees  1 , N Ketharanathan  2 , I M M H Oen  3 , M G A Baartmans  4 , J S H A Koopman  5
Affiliations
Case Reports

Beware of thermal epiglottis! A case report describing 'teapot syndrome'

V Verhees et al. BMC Anesthesiol. .

Abstract

Background: The type of scalding injury known as 'teapot syndrome', where hot liquid is grabbed by the child with the aim of ingestion and falls over a child causing burns on the face, upper thorax and arms, is known to cause peri-oral and facial oedema. Thermal epiglottitis following scalds to face, neck and thorax is rare and can occur even in absence of ingestion of a damaging agent or intraoral burns, Awareness of the possibility of thermal epiglottitis, also in scald burns, is imperative to ensure prompt airway protection.

Case presentation: We report the case of a child with thermal epiglottitis after a scalding burn from boiling milk resulting in mixed deep burns of the face, neck and chest, but no history of ingestion. Upon presentation there was a progressive stridor and signs of respiratory distress requiring intubation. Laryngoscopy revealed epiglottis oedema, confirming the diagnosis of thermal epiglottitis. Final extubation took place 5 days after initial burn.

Conclusions: Thermal epiglottitis following scalds to face, neck and thorax is rare and can occur even in absence of ingestion and intra-oral damage. Burns to the peri-oral area should raise suspicion of additional damage to oral cavity and supraglottic structures, even in absence of intra-oral injury or initial respiratory distress. Awareness of the occurrence of thermal epiglottitis in absence of intra-oral injury is important to diagnose impending upper airway obstruction requiring intubation.

Keywords: Airway injury; Burn injury; Thermal epiglottitis.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Written informed consent publication and use of photo material was obtained from the parents, as the patient is a minor.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
a Injuries upon presentation; b development of oedema 48 h post-burn; c inspection of injuries 21 days post-burn
Fig. 2
Fig. 2
Fiberscopy 3 days post-burn after self-extubation showing an (a): airway with fibrinous coating; (b) oedematous epiglottis and (c): airway
Fig. 3
Fig. 3
Fiberscopy 5 days post-burn showing (a): reduction of oedema; (b): restored airway; (c): pale arytenoid cartilage; d: thin epiglottis
Fig. 4
Fig. 4
Timeline case report
See this image and copyright information in PMC

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