Non-infective supraglottitis: two cases of unusual aetiology

Supraglottitis is an ear, nose and throat emergency where swelling of the laryngeal structures can threaten to fatally obstruct the airway. Most cases of supraglottitis are of infective origin but other rarer causes have been documented. We present two patients who presented with stridor and were found to have supraglottic oedema on fibreoptic nasolaryngoscopy. Both patients presented with odynophagia and progressive dyspnoea and were initially medically managed to stabilise their airway. This included intravenous steroids, nebulised epinephrine and intravenous antibiotics. After this initial treatment they both required investigation and optimisation of their underlying medical conditions (rheumatoid arthritis with possible systemic lupus erythematosus and nephrotic syndrome) as more definitive management.