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Age: 1

Sex: Female

Indication: Stridor

Save ("V")

Case #17


Findings

  • Marked thickening of the epiglottis and aryepiglottic folds


Diagnosis

  • Epiglottitis

Sample Report

Marked thickening of the epiglottis and aryepiglottic folds concerning for epiglottitis. Recommend ENT consultation.

No retropharyngeal soft tissue thickening.


Discussion

  • Epiglottitis has become incredibly rare (but may make a comeback if anti-vaccination trends continue), but even though it is a rare diagnosis, it is important to be familiar with it since it is a diagnosis that can be made on imaging and can be life threatening if not promptly addressed
  • Remember that while epiglottitis was classically a disease of young children, it now more commonly occurs in teenagers and young adults
  • To make the diagnosis, both the epiglottis and aryepiglottic folds should be thickened. Slight oblique patient positioning or omega appearance of the epiglottis (a normal variant) can give the appearance of epiglottic edema, but neither should have associated aryepiglottic fold thickening


Images

Normal comparison on the left, patient with epiglottitis on the right. Note the marked thickening of the epiglottis (blue arrows) and aryepiglottic folds (yellow arrows) in the patient on the left.

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