Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 8-28: Common Laryngeal Disorders + Key Features Download Section PDF Listen +++ ++ Suspect epiglottitis (or, more correctly, supraglottitis) when a patient complains of Rapidly developing sore throat Odynophagia (pain on swallowing) which is disproportional to apparently minimal oropharyngeal findings on examination May be viral or bacterial in origin It is more common in persons with diabetes + Clinical Findings Download Section PDF Listen +++ ++ Lateral plain film radiographs may demonstrate an enlarged epiglottis (the epiglottis "thumb sign") Swollen, erythematous epiglottis on laryngoscopy + Diagnosis Download Section PDF Listen +++ ++ Unlike in children, indirect laryngoscopy is generally safe + Treatment Download Section PDF Listen +++ ++ Hospitalization and initial admission to a monitored unit Intravenous antibiotics (eg, ceftizoxime, 1–2 g every 8–12 hours; or cefuroxime, 750–1500 mg every 8 hours) Dexamethasone, usually 4–10 mg as initial bolus and then 4 mg every 6 hours intravenously, and observation of the airway Corticosteroid may be tapered as signs and symptoms resolve. Similarly, substitution of oral antibiotic may be appropriate to complete a 10-day course When epiglottitis is recognized early in the adult, it is usually possible to avoid intubation Less than 10% of adults require intubation Indications for intubation Dyspnea or rapid pace of pharyngitis (where progression to airway compromise may occur before the effects of corticosteroid and antibiotic take hold) Endolaryngeal abscess noted on CT imaging If the patient is not intubated, monitor oxygen saturation with continuous pulse oximetry