Emberey Jonathan, Velala S Srinath, Marshall Ben, Hassan Adil, Meghjee Salim Pl, Malik M Jamil, Hussain Muhammad
Department of Respiratory Medicine, Barnsley Hospital NHS Foundation Trust, Barnsley, UK.
Department of ENT/Otolaryngology - Head & Neck Surgery, Barnsley Hospital NHS Foundation Trust, Barnsley, UK.
Eur J Case Rep Intern Med. 2021 Mar 3;8(3):002280. doi: 10.12890/2021_002280. eCollection 2021.
A 53-year-old man presented acutely to the Accident and Emergency department with a 2-day history of progressive odynophagia and shortness of breath. The patient had stridor at rest and acute epiglottitis was suspected. The patient was transferred urgently to theatre for intubation but due to a severely oedematous airway, this was unsuccessful and emergency tracheotomy was performed by the ENT team. Throughout admission the only positive microbiological sample was a nasopharyngeal swab for SARS-CoV-2 infection. In the absence of other positive microbiology, it is highly likely that COVID-19 was the aetiological cause of acute epiglottitis in this instance.
COVID-19 infection is a novel disease with multiple presentations; it should be considered as a possible causative organism in patients presenting with acute epiglottitis.Due to the time delay in taking samples for microbiology and results being available, treatment should be commenced with antibiotics, nebulised adrenaline and steroids to cover bacterial infection.Presentation can occur following a delayed inflammatory response and treatment should target the organ system involved.
一名53岁男性急症就诊于急诊部，有进行性吞咽痛和呼吸急促2天病史。患者静息时有喘鸣，怀疑为急性会厌炎。患者被紧急转至手术室插管，但由于气道严重水肿，插管未成功，耳鼻喉科团队进行了紧急气管切开术。整个住院期间，唯一呈阳性的微生物样本是一份用于检测SARS-CoV-2感染的鼻咽拭子。在没有其他阳性微生物学结果的情况下，很可能COVID-19是本例急性会厌炎的病因。
COVID-19感染是一种具有多种表现的新型疾病；对于出现急性会厌炎的患者，应将其视为可能的致病病原体。由于采集微生物样本及获得结果存在时间延迟，应开始使用抗生素、雾化肾上腺素和类固醇进行治疗，以覆盖细菌感染。症状可能在延迟的炎症反应后出现，治疗应针对受累的器官系统。
