Epiglottitis

Case report:

The emergency doctor is brought in early in the morning for a two-year-old girl from her parents in the house after the young daughter has suddenly developed a high level of inspiratory stridor within a few hours under an existing for a few days of infection of the upper airways, which to a significant cyanosis, tachycardia and massive unrest had resulted in the young patient. The physical examination no evidence of acute tonsillopharyngitis or an obstruction of the lower respiratory tract, so that the emergency caused an immediate hospitalization accompanied by a doctor. There the patient in the ICU is sedated, treated with oxygen and immediately receives high doses of steroids and antibiotics i.v.

Diagnosis and Etiology:

The rapid development of this syndrome with the typical inspiratory stridor without coughing indicates an acute epiglottitis. The hospitalization is useful in this acute disease, because in severe cases, intubation or tracheotomy and targeted parenteral antibiotic therapy is necessary. The causative agent of this acute bacterial infection of the image is Haemophilus influenzae.

Therapy:

The sensitivity of Haemophilus influenzae in Germany is still low compared to many antibiotics groups. To a lesser extent (5-8%) make up this exciting beta-lactamases and are therefore in this situation insensitive aminopenicillins as ampicillin (BINOTAL among others) or amoxicillin (Clamoxyl et al). Parenteral treatment with a cephalosporin such cefotiam (SPIZEF), cefuroxime (CEFUROXIME et al) or cefotaxime (Claforan) carried out in a body weight of the child matched dosage - In this life-threatening situation is therefore - in order to exclude any risk. Treatment should be about seven to ten days, which can be converted to oral therapy after the acute symptoms.