Epiglottitis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Differentiating Epiglottitis from other Diseases

Epiglottitis must be differentiated from other respiratory diseases and conditions that may cause throat pain and airway obstruction:

• Croup (Laryngotracheobronchitis)
• Foreign body obstruction
• Subglottic stenosis
• Pharyngitis
• Tonsilitis
• Angioedema 
• Uvulitis
• Retropharyngeal or peritonsilar abscesses
• Bacterial tracheitis

Variable		Croup	Epiglottitis	Pharyngitis	Bacterial tracheitis	Tonsilitis	Retropharyngeal abscess
Presentation	Cough	✔	—	sore throat, pain on swallowing, fever, headache, abdominal pain, nausea and vomiting	barking cough, stridor, fever, chest pain, ear pain, difficulty breathing, headache, dizziness.	sore throat, pain on swallowing, fever, headache, cough	neck pain, stiff neck, torticollis fever, malaise, stridor, and barking cough
	Stridor	✔	✔
	Drooling	—	✔
			Other symptoms include difficulty breathing, fever, chills, difficulty swallowing, hoarseness of voice
Causes		Parainfluenza virus
Physical exams findings			Cyanosis, Cervical lymphadenopathy, Inflammed epiglottis				and may have enlarged cervical lymph nodes
Age commonly affected		Mainly 6 months and 3 years old rarely, adolescents and adults	Used to be mostly found in pediatric age group between 3 to 5 years, however, recent trend favors adults as most commonly affected individuals with a mean age of 44.94 years.	Mostly in children and young adults, with 50% of cases identified between the ages of 5 to 24 years.		Primarily affects children between 5 and 15 years old.
Imaging finding		Steeple sign on neck X-ray	Thumb print sign on neck x-ray
Treatment