, Volume 27, Issue 2, pp 316-317
Date: 18 Oct 2012

Acute epiglottitis in the era of post-Haemophilus influenzae type B (HIB) vaccine

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To the Editor:

We report a case of an HIB-vaccinated 16-year-old male who developed sudden onset fever, sore throat, dysphagia, and dyspnea. He was brought to the operating room (OR) for controlled intubation. A deep plane of anesthesia was obtained via inhalational anesthesia (end tidal sevoflurane 4 % in 100 % O2) with the patient breathing spontaneously in a sitting position. Direct laryngoscopy revealed grade IV view secondary to an edematous epiglottis. The airway was secured with a 6.5-mm endotracheal tube (ETT), by use of a Parsons laryngoscope (Fig. 1). After treatment with intravenous antibiotics for 24 h, he was extubated and discharged.Fig. 1

Epiglottitis in an HIB-vaccinated patient

The incidence of acute epiglottitis in children has decreased from 4.9 to 0.02 cases/100,000/year as a result of vaccination with HIB [1]. Stridor, tachypnea, and fever are commonly associated with epiglottitis in children who will need airway intervention [2]. Older children, such as ours, may hav