L119

LARYNX - Acute epiglottitis

Description
The epiglottis is markedly swollen and distorted; the epiglottic folds are swollen and haemorrhagic, and there is general swelling of the tissues in the surrounding area. The vocal chords do not appear to be involved, but there is an area of haemorrhage in the tracheal mucosa immediately below the chords.
History
This man presented at the age of 30 with a sore throat of a few hours duration. Examination showed an exudate over the left tonsil. He was however able to drink a glass of water without difficulty. Oral Penicillin and Panadol was prescribed. Half an hour later his wife rang to say that he could not swallow the tablets. Three hours after the onset of symptoms he had an acute and severe airways obstruction, he was blue in colour and could not be intubated. A tracheostomy was carried out but 40 minutes later he had a cardiac arrest.