Airway Watch: A Rare Case of Adult Epiglottitis

Epiglottitis is an acute inflammatory condition involving the epiglottis and other supraglottic structures that may lead to airway obstruction. Historically, this condition primarily affected the pediatric population and was secondary to Haemophilus influenzae (Hib) infection. Since the vaccination program against Hib serotype B started at age two months, the number of affected pediatric patients has seen a drastic decline. Epiglottitis is now a condition that primarily affects adults. This case report presents a 58-year-old fully vaccinated female presenting with severe throat pain, odynophagia, subjective dyspnea, and chills for two days. During her evaluation, the patient underwent bedside nasopharyngoscopy by the emergency medicine team and was treated appropriately prior to evaluation by an otolaryngologist (ENT). The patient underwent a second nasopharyngoscopy with ENT 75 minutes after the original, which demonstrated vast improvements in the patient's clinical picture, allowing her to avoid intubation. This report highlights the importance of having epiglottitis on the differential for adults, the importance of the emergency medicine physician in performing nasopharyngoscopy, and early intervention with antibiotics and corticosteroids* to improve patient outcomes.