Epiglottitis

• Life-threatening condition, caused by Haemophilus influenzae, and usually occurring in 2–6Y children. Short history, high fever, dysphagia, drooling, and forward-sitting posture. The main DD is acute laryngo-tracheo-bronchitis (croup) which is a common viral illness, most frequently occurring in the under four-year-old.

• Bronchiolitis occurs mainly in children under 18 months and is an infection of the bronchioles, usually by respiratory syncytial virus (RSV.

• Epiglottitis is a medical emergency, and it is important to recognise these patients. On presentation, it is imperative to confirm the diagnosis before complications occur, including airway obstruction. Children typically present in a ‘tripod’ position (trunk leaning forward, his neck hyperextended, and his chin thrust forward) or ‘sniffing’ position indicative of respiratory distress. In primary care, if epiglottitis is suspected, arrange a 999-ambulance transfer to the ENT or paediatric team through the emergency department.

Resource

• Hitti E. Acute epiglottitis. InnovAiT 2020; 13(10): 608–612.

Supraglottitis

• Adult supraglottitis: a potential airway emergency that can present in primary care (BJGP)

Hoarse voice

• GOR, recurrent laryngeal nerve palsy (post neck surgery/lung ca), MND (with dysphagia, other motor sx), hypothyroidism, CVA, laryngeal ca 

Larynx cancer

• Cancer of the larynx (NHS Choices)

Laryngitis

• Laryngitis (NHS Choices)