A Case of Adult Epiglottitis in a Patient With Uncontrolled Diabetes and Occupational Risks

Area of Science:

• Otolaryngology
• Emergency Medicine
• Internal Medicine

Background:

• Epiglottitis, characterized by epiglottic inflammation, necessitates prompt diagnosis for effective airway management.
• Treatment strategies for epiglottitis range from conservative measures to emergent airway intervention, depending on obstruction severity.

Observation:

• A 39-year-old male with uncontrolled diabetes and smoking presented with sore throat, odynophagia, and difficulty swallowing.
• Physical examination revealed drooling, muffled voice, pharyngeal swelling, and erythema; laboratory tests showed leukocytosis and hyperglycemia (HbA1c 14.3%).
• Lateral neck X-ray and laryngoscopy confirmed epiglottitis with patent airway, and the patient was exposed to metal shavings at work.

Findings:

• The patient, despite risk factors, did not require intubation and responded well to intravenous dexamethasone, antibiotics, and supportive care.
• Diagnosis of epiglottitis was confirmed via imaging and direct visualization.
• Negative infectious workup ruled out common infectious etiologies.

Implications:

• This case underscores the importance of considering occupational hazards alongside traditional risk factors in adult epiglottitis.
• Prompt diagnosis and risk factor identification are crucial for successful epiglottitis management in adults.
• Conservative management was effective in this case, highlighting the spectrum of epiglottitis treatment needs.