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Published on: May 16, 2015
Epiglottitis in infants less than two years of age
R J Brilli1, G Benzing, D H Cotcamp
1Department of Pediatrics, Children's Hospital Medical Center, University of Cincinnati, OH 45229-2899.
Insights
Epiglottitis in infants presents variably, often lacking fever and mimicking viral croup. Early recognition of these unique signs in young children aids prompt diagnosis and safe management.
Area of Science:
- Pediatrics
- Infectious Diseases
- Otolaryngology
Background:
- Epiglottitis is a serious upper airway infection.
- Children under two years old account for up to 25% of epiglottitis cases.
- Clinical presentation in infants can differ significantly from older children.
Purpose of the Study:
- To characterize the clinical presentation of epiglottitis in children under two years of age.
- To identify key signs and symptoms that differentiate infant epiglottitis from other conditions.
Main Methods:
- Retrospective review of 41 children under two years of age diagnosed with epiglottitis.
- Analysis of clinical signs, symptoms, and patient history.
Main Results:
- Infant epiglottitis presentation is variable.
- Commonly observed signs in infants include absence or low-grade fever, antecedent upper respiratory infection (URI) history, and croupy cough.
- These symptoms can be mistaken for viral croup.
Conclusions:
- Awareness of specific presenting findings in infants is crucial for prompt diagnosis of epiglottitis.
- Early diagnosis facilitates timely management.
- Young infants with epiglottitis can be safely managed with short-term nasotracheal intubation.
Abstract:
A retrospective review of 41 children less than two years of age was conducted to characterize the clinical presentation of epiglottitis in this young age group. Up to 25% of all cases of epiglottitis occur in children less than two years of age. The clinical presentation of patients in this young age group is variable. Signs and symptoms not routinely described in children over two years of age with epiglottitis but often observed in infants with epiglottitis include the absence of fever, the presence of only low grade fever, a significant history of antecedent URI, and a prominent "croupy" cough. These same features are often noted in children with the viral croup syndrome. A diagnosis of this life-threatening illness may be made promptly through an awareness of the presenting findings observed in infants. Young infants with epiglottitis can be safely managed with short-term nasotracheal intubation.
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