• Isolate patients with suspected epiglottitis in a side room and use PPE for droplet precautions.
  • Haemophilus influenzae Type B (HiB) is now uncommon.
  • Involve ENT early.
  • Suspected epiglottitis can mimic a retropharyngeal abscess.
  • Use PPE for airborne precautions when performing airway interventions as there is a risk of Neisseria meningitidis causing epiglottitis.

Required investigations

Required Investigations

  • Blood cultures
  • EDTA blood: request on TRAK: Bacterial Meningitis Profile
  • Bacterial throat swab if safe to perform (specifically request culture for Neisseria & Haemophilus)

Antimicrobial recommendation

Recommended total duration: Duration dependent on organism and severity, discuss with microbiology

Antimicrobial recommendation

Ceftriaxone 2g every 12 hours IV

AND

Metronidazole 500mg every 8 hours IV

If known MRSA, consider adding:

Vancomycin (use NHS Lothian Calculator located AMT intranet page) select trough level 15-20mg/L

Severe Penicillin Allergy or known cephalosporin allergy

Vancomycin (use NHS Lothian Calculator located AMT intranet page) select trough level 15-20mg/L

PLUS

Ciprofloxacin 400mg every 12 hours IV

PLUS

Metronidazole 500mg every 8 hours IV

 

IV to oral switch

Review microbiology investigations

Antimicrobial recommendation Co-amoxiclav 625mg every 8 hours orally
Penicillin Allergy Phone microbiology

 

Notes

Notes

Likely organisms: Neisseria meningitidis, Streptococci, Staphylococcus aureus; historically Haemophilus influenzae type B, but with routine vaccination no longer prevalent.