Delayed Presentation of Thermal Epiglottitis in a Toddler: A Case Report

Abstract

A minor insult to the pediatric airway can have a devastating result. Unfortunately, the signs and symptoms of obstruction might not be present immediately and take some time to develop. Therefore, physicians should have a higher index of suspicion for airway obstruction in children that present with a history of ingestion of scalding liquid. Signs and symptoms of infectious vs noninfectious epiglottis do overlap and the key to differentiate is by careful history and physical exam, especially in nonverbal children. A secondary bacterial infection might complicate thermal epiglottis and make the picture a bit confusing. Therefore, a coordinated approach through a multidisciplinary team is indicated from the start and these cases should be managed and referred to a higher center.

Keywords: airway; burn; ent - ear nose and throat; pediatrics emergency; thermal epiglottitis.

Figure 1. Upper airway examination under general anesthesia revealed severe epiglottic, aryepiglottic fold, arytenoid, and vocal cord edema and erythema.

Figure 2. Upper airways examination five days later revealed marked improvement in supraglottic and glottic edema and erythema.