Acute Epiglottitis Due to COVID-19 Infection

A 53-year-old man presented acutely to the Accident and Emergency department with a 2-day history of progressive odynophagia and shortness of breath. The patient had stridor at rest and acute epiglottitis was suspected. The patient was transferred urgently to theatre for intubation but due to a severely oedematous airway, this was unsuccessful and emergency tracheotomy was performed by the ENT team. Throughout admission the only positive microbiological sample was a nasopharyngeal swab for SARS-CoV-2 infection. In the absence of other positive microbiology, it is highly likely that COVID-19 was the aetiological cause of acute epiglottitis in this instance.

COVID-19 infection is a novel disease with multiple presentations; it should be considered as a possible causative organism in patients presenting with acute epiglottitis.Due to the time delay in taking samples for microbiology and results being available, treatment should be commenced with antibiotics, nebulised adrenaline and steroids to cover bacterial infection.Presentation can occur following a delayed inflammatory response and treatment should target the organ system involved.