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Abstract: Epiglottitis includes acute epiglottitis and chronic epiglottitis. Acute epiglottitis is a common clinical condition, but less known is that it can be a life-threatening disease that can lead to airway obstruction and asphyxia in severe cases. After completing relevant examinations, the patient was diagnosed with epiglottitis. After active anti-inflammatory treatment, the patient’s symptoms such as sore throat and dyspnea improved and the disease eventually recovered.
Basic information】Male, 59 years old
Disease Type】Acute epiglottitis
Hospital】Northern War Zone General Hospital
Date of consultation】August 2021
Treatment plan】Intravenous infusion (cefoperazone sodium sulbactam sodium for injection, compound sodium chloride injection, glucose injection) + oral medication (methylprednisolone tablets) + nebulized medication (budesonide suspension for inhalation)
Treatment period】5 days of inpatient treatment
Treatment effect】Epiglottis swelling improved, sore throat, painful swallowing, and labored breathing disappeared.
I. Initial consultation
The patient described his medical history. He had a cold 1 week ago, and his cold symptoms improved significantly after applying anti-cold medication on his own, but in the past 3 days, he developed sore throat and swallowing pain when eating, without medication. After taking the medical history, the patient was given a complete fiberoptic laryngoscopy, which showed that the mucous membrane of the throat was congested, the lingual surface of the epiglottis was swollen and the lateral edge of the epiglottis, and no new growth was seen in the larynx.
II. Treatment
According to the patient’s current status, the patient was given conservative treatment with medication and was recommended to be hospitalized. The patient was given anti-inflammatory treatment with cefoperazone sodium sulbactam sodium for injection, and the pharyngeal secretions were cultured for bacteria, and the antibiotics could be adjusted in time after the drug sensitivity results were returned. At the same time, the patient was given methylprednisolone tablets for shock treatment to reduce epiglottis edema, with the application of inhalation budesonide suspension for nebulization; because the patient has difficulty in eating, the patient was given compound sodium chloride injection and glucose injection for rehydration treatment to maintain vital signs, and the accompanying family members were instructed to closely observe the patient’s respiratory changes, and the patient and family members understood the need to cut the tube in case of obvious respiratory effort.
III. Treatment effect
After 2 hours of medication, the patient’s respiratory effort improved, the patient’s mental state improved significantly, and the next morning, the patient complained of improvement in sore throat, but still felt significant pain when swallowing, but no respiratory distress, the body temperature returned to normal, and the swelling of the lingual surface of the patient’s epiglottis was reduced by indirect laryngoscopy, and the patient needed to continue to apply methylprednisolone tablets and injectable cefoperazone sodium sulbactam sodium to consolidate treatment to avoid repeated inflammation. The patient’s epiglottis swelling had improved significantly by 3 days of treatment, so in order to avoid hormonal side effects, the drug was discontinued and the application of cefoperazone sodium sulbactam sodium for injection was continued for consolidation; by 5 days of hospitalization, the patient’s sore throat and swallowing pain had completely disappeared and the general condition of the patient was good, so the patient was discharged from the hospital.
IV. Notes
I am very glad that the patient’s condition has recovered, but I would like to remind the patient to pay attention to the following points.
1. Patients are advised to avoid eating spicy and oily food, such as chili, fish and shrimp, after discharge.
2, can not smoke and drink alcohol to reduce the stimulation of the mucous membrane of the throat, can not stay up late need to exercise properly to improve resistance.
3, after discharge from the hospital, it is recommended that patients can continue to apply inhalation budesonide suspension to do nebulization for 3 days to consolidate the effect.
4, go out to pay attention to weather changes, timely increase and decrease clothing, to avoid the emergence of colds.
5.If any discomfort occurs during the medication period, stop the medication in time and go to the hospital for further consultation, and return to the hospital for laryngoscopy if necessary.
V. Personal insight
Acute epiglottitis is a clinical emergency in otorhinolaryngology, its onset is rapid, the condition develops especially fast, and the main thing is life-threatening, so like the patient in this case, when there is sore throat, painful swallowing and labored breathing in life, we must pay attention to it, go to the hospital in time, improve laryngoscopy, and actively anti-inflammatory and anti-swelling after clear diagnosis, apply hormone shock treatment, and if the application of drugs is not well controlled, tracheotomy is needed if necessary. Avoid adverse consequences.