Epiglottitis.

Epiglottitis is a life-threatening infection due to Hemophilus influenzae causing respiratory obstruction. Commonly presenting in children under 5 years of age, the obstruction progresses rapidly with associated inspiratory stridor, muffled voice, fever and systemic toxicity. The epiglottis is markedly enlarged on lateral neck X-ray. Once the diagnosis is considered, the patient should always be accompanied by a clinician skilled in airway management, prepared to intervene should acute obstruction occur. Optimally, patients are intubated electively in the operating room by a team of specialized physicians. Nasal or oral tracheal intubation is commonly utilized although a tracheostomy is an alternative means of securing the airway. Positive pressure ventilation may be successful as a temporizing measure if obstruction occurs until the airway is stabilized. Chloramphenicol should be initiated once airway stabilization has been achieved.