Epiglottitis

J05.1

DESCRIPTION

Acute epiglottitis can result in severe, sudden or progressive airway obstruction. Acute epiglottitis can be caused by bacteria (e.g. H. influenzae ), viruses (e.g. herpes simplex) and non-infectious insults (trauma, chemicals, heat).

GENERAL MEASURES

Airway management may require urgent specialist advice.
Adequate hydration.

MEDICINE TREATMENT

Humidified oxygen.

Antibiotic therapy

Total duration of therapy: 10 days

  • Ceftriaxone, IV, 1 g daily.

Follow with oral therapy as soon as patient can swallow and the temperature is <37.8oC for 24 hours, to complete the 10-day course:

  • Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly.

Severe penicillin allergy to amoxicillin/clavulanic acid, oral: (Z88.0)

  • Macrolide, e.g.:
  • Azithromycin, oral, 500 mg daily for 3 days.

LoEIII [1]

Acute stage

Imminent airway obstruction:

  • Hydrocortisone, IV, 100 mg immediately as a single dose.

LoEIII [2]

AND

  • Adrenaline (epinephrine) 1:1 000, 1 mL nebulised.
    • Dilute to 5 mL with sodium chloride 0.9% and administer 4–6 hourly.

LoEIII [3]