Acute epiglottitis after COVID‐19 infection

Abstract

The coronavirus disease 2019 (COVID-19), first described in late 2019, is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In COVID-19, mortality is mainly caused by acute respiratory failure, whereas morbidity has been described for all major organ systems. 1 Verified secondary bacterial infections in COVID-19 are rare, although antimicrobials are commonly used empirically. 2 A case report of a 60-year-old obese male patient with epiglottitis and subsequent positive SARS-CoV-2 RT-PCR was published by Fondaw et al 3 . This patient had initially presented with dyspnea and stridor and had to undergo emergency cricothyroidotomy for acute epiglottitis. The initial SARS-CoV-2 RT-PCR was negative, but on day two the chest X-ray showed signs consistent with COVID-19 pneumonitis and a repeat test confirmed COVID-19. The patient's condition improved, and he could be weaned off the ventilator on day seven.Here, we present a second case of likely COVID-19associated epiglottitis. | CASE REPORTA 29-year-old man without pre-existing medical conditions tested COVID-19 positive after having headache, fatigue, and mild rhinitis. Within a week, his COVID-19 symptoms improved. After an asymptomatic period of 12 days, the patient developed throat pain. He was referred to the Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) Emergency Department at Helsinki University Hospital due to respiratory distress and muffled voice three weeks after the first symptoms associated with COVID-19 infection. His general health status was good, and vital signs were stable. Nasofiberoscopy showed a hyperemic epiglottis that was swollen asymmetrically. Yellowish, pus-like fluid existed in

Acute odynophagia: A new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden

“…Only one patient presented with swelling of an arytenoid region. However, in the literature search we identified seven cases of acute epiglottitis with concomitant COVID‐19 infection [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ], so this diagnosis should be considered and promptly excluded, especially if a patient is presenting with a typical clinical triad.…”

COVID-19 presenting as acute epiglottitis: A case report and literature review

“…The descriptive laryngeal findings were similar to those of common acute epiglottitis. Only one report presented an image of acute epiglottis; the larynx was partially affected by erosive lesions [5] . These results suggest that necrotic-like erosive lesions may characterize COVID-19-induced acute laryngitis.…”

“…Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a rapidly progressing respiratory disease that also affects the upper aerodigestive tract via angiotensin-converting enzyme 2 or transmembrane protease/serine subfamily member 2 receptors [ 1 , 2 ], causing a sore throat and odynophagia. There are reports of COVID-19-induced acute laryngitis requiring emergency treatment, indicated by acute epiglottitis in adults and croup in infancy [3] , [4] , [5] , [6] , [7] , [8] , [9] . Frequently, this requires urgent airway management, which generates aerosols and increases the risk of spreading the infection.…”

“…Thus, understanding the laryngeal abnormalities associated with COVID-19 is essential. However, few laryngo-fiberscope images of COVID-19-induced acute laryngitis have been presented [5] . Additionally, the time between acute laryngitis onset and pneumonia has not been reviewed.…”

“…There are reports of COVID-19-induced acute laryngitis requiring emergency treatment, indicated by acute epiglottitis in adults and croup in infancy [3][4][5][6][7][8][9]. Frequently, this requires urgent airway management, which generates aerosols and increases the risk of spreading the infection.…”