Introduction to acute epiglottitis

Acute epiglottitis (supraglottitis) is a life-threatening airway condition caused by infection of the epiglottis and surrounding structures; patients often have sepsis or septic shock. With widespread use of the Haemophilus influenzae type b (Hib) vaccine, epiglottitis has become rare in children. Although still rare, epiglottitis is more common in adults than in childrenBaird 2018. Differential diagnoses include laryngitis, pharyngitis, caustic or foreign body ingestion or aspiration, and anaphylaxis.

Acute epiglottitis is most commonly caused by bacteria, although the causative organism is often not identified. Various bacteria may be implicated, including Streptococcus pneumoniae, Streptococcus pyogenes (group A streptococcus), Staphylococcus aureus (including methicillin-resistant strains), Haemophilus influenzae, Klebsiella pneumoniae and Fusobacterium necrophorumCunningham 2019. In patients with immune compromise, a broader range of bacterial pathogens may also be seenBridwell 2022.

Epiglottitis is less commonly associated with viral infections, including COVID-19. Epiglottitis associated with fungal infections is also uncommon, but predominantly occurs in patients with immune compromiseIwamoto 2021.