Pediatric Epiglottitis
A 4-year-old boy developed epiglottitis with fever, sore throat and inspiratory stridor over the course of an afternoon. By direct epiglottic culture group G Streptococcus was identified as the pathogen. The presentation and clinical course of epiglottitis caused by each of the beta-hemolytic streptococcal pathogens is similar, and each is very different from Haemophilus influenzae type b disease.
The widespread use of immunizations against Haemophilus influenzae type b (Hib) has significantly decreased the incidence of meningitis and sepsis caused by this invasive organism. A welcomed side effect of this immunization program has been a 10-fold decrease in the incidence of epiglottitis (supraglottitis). Hib was the dominant cause of epiglottitis in the early 1980s with other organisms accounting for ~1% of cases. As Hib epiglottis has disappeared, other organisms including Streptococcus pneumoniae,Haemophilus parainfluenzae,Staphylococcus aureus,Candida spp., viral pathogens and group A, B and C streptococci have emerged as increasingly likely etiologies for this disease. Epiglottitis may present differently when these alternative microorganisms are the cause.
A 4-year-old boy developed epiglottitis with fever, sore throat and inspiratory stridor over the course of an afternoon. By direct epiglottic culture group G Streptococcus was identified as the pathogen. The presentation and clinical course of epiglottitis caused by each of the beta-hemolytic streptococcal pathogens is similar, and each is very different from Haemophilus influenzae type b disease.
The widespread use of immunizations against Haemophilus influenzae type b (Hib) has significantly decreased the incidence of meningitis and sepsis caused by this invasive organism. A welcomed side effect of this immunization program has been a 10-fold decrease in the incidence of epiglottitis (supraglottitis). Hib was the dominant cause of epiglottitis in the early 1980s with other organisms accounting for ~1% of cases. As Hib epiglottis has disappeared, other organisms including Streptococcus pneumoniae,Haemophilus parainfluenzae,Staphylococcus aureus,Candida spp., viral pathogens and group A, B and C streptococci have emerged as increasingly likely etiologies for this disease. Epiglottitis may present differently when these alternative microorganisms are the cause.