Haemophilus influenzae type B is the usual infective agent,
although the incidence has significantly decreased with HiB
Children between the ages of 2 and 7 years of
age are affected, with a peak incidence in 3-year-olds. The
disease typically presents with a rapid onset of high fever,
toxicity, agitation, stridor, dyspnea, muffled voice, and
painful swallowing.
Examination will reveal a child in
distress, seated, and leaning forward with the mouth open
and drooling. If supraglottitis is suspected, no further
examination is recommended outside of a controlled setting.
In acute supraglottitis, the risk of complete obstruction is
high and the airway has to be secured. Endotracheal
intubation is the method of choice as the supraglottic
swelling is usually reversible in a few days, unless
complications occur. Senior anaesthetic help, with
experience in managing the compromised airway, must be
sought. An oedematous, cherry red epiglottis with
inflammation of the surrounding supraglottis is seen on
direct laryngoscopy. Intravenous antibiotics are required.



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