Document Detail


Necrotizing epiglottitis and hemophagocytic lymphohistiocytosis.
MedLine Citation:
PMID:  19062109     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
With the introduction of vaccination for haemophilus influenza, the epidemiology of epiglottitis in children has changed. Classic childhood epiglottitis is now rare, and unusual forms of the disease may be seen. Nectrotizing epiglottitis is an extremely rare form of epiglottitis. Only four cases of nectrotizing epiglottitis have been previously reported, and all cases were in immunocompromised adult patients. Hemophagocytic lymphohistiocytosis is a rare condition characterized by high fevers, hepatosplenomegaly, and cytopenias caused by an abnormal proliferation and activation of macrophages. We report the first case of a previously healthy 5-year-old male presenting with acute onset of airway distress and pancytopenia. Subsequent airway evaluation led to the diagnosis of nectrotizing epiglottitis, and he was simultaneously diagnosed with infection-induced hemophagocytic lymphohistiocytosis. The patient recovered with intubation and antibiotics. Follow-up direct laryngoscopy revealed an epiglottis remnant with approximately 50% loss of epiglottic tissue. The presentation and pathophysiology of this unusual manifestation of epiglottitis and hemophagocytic lymphohistiocytosis will be reviewed. In the post-haemophilus influenze vaccination era, the pediatric otolaryngologist must be familiar with unusual forms of epiglottitis and its associated manifestations.
Authors:
Michael S Kong; Samuel H Engel; George H Zalzal; Diego Preciado
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International journal of pediatric otorhinolaryngology     Volume:  73     ISSN:  0165-5876     ISO Abbreviation:  Int. J. Pediatr. Otorhinolaryngol.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-02-03     Completed Date:  2009-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003603     Medline TA:  Int J Pediatr Otorhinolaryngol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  119-25     Citation Subset:  IM    
Affiliation:
National Capital Consortium, Otolaryngology, Head and Neck Surgery, National Naval Medical Center, Bethesda, MD 20889, USA. michael.kong@med.navy.mil
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MeSH Terms
Descriptor/Qualifier:
Bacterial Infections / complications
Child, Preschool
Epiglottitis / etiology*,  pathology*,  therapy
Humans
Lymphohistiocytosis, Hemophagocytic / complications*,  diagnosis*,  microbiology
Male
Necrosis / diagnosis,  etiology,  therapy

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