Paediatric Imaging

Epiglottitis, acute

a life-threatening infection caused by Haemophilus influenzae in which there is oedema of the epiglottis and aryepiglottic folds (often a purely supraglottic involvement) causing airway obstruction. It is characterised by fever, sore throat, restlessness and rapidly progressive respiratory obstruction. The young child often assumes an upright position with the head held forward and the tongue protruding. Approximately 25% of children with proven acute bacteria epiglottitis also have subglottic oedema.

The lateral radiograph demonstrates distension of the larynx and marked enlargement of the epiglottis (omega-shaped) (Fig.1) and thickening of the aryepiglottic folds. Ballooning of the hypopharynx and pyriform sinuses with cervical kyphosis are often accompanying features. Radiographs should not be performed as a routine but, when needed, the patient must be accompanied by an experienced physician who is ready to manage the airway as complete closure of the airway may occur.

LT

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Fig.1

There is thickening of the epiglottis and ballooning of the hypopharynx, typical of acute epiglottitis.
Epiglottitis, acute, Fig.1