Multipathogenic necrotising supraglottitis in an immunocompetent patient

BMJ Case Rep. 2017 Jun 18:2017:bcr2017219631. doi: 10.1136/bcr-2017-219631.

Abstract

Supraglottitis is a potentially life-threatening condition. It is now uncommon due to the Haemophilus influenzae type B vaccination and is more recently caused by Streptococcus pneumoniae, S. pyogenes, H. influenzae non-type B, H. parainfluenzae, Staphylococcus aureus and Pasteurella multocida Very rarely, it can cause necrotising supraglottitis/epiglottitis, and this has been reported in immunocompromised individuals. We present a unique case of multipathogenic supraglottitis causing laryngeal fibrinoid necrosis in an immunocompetent patient. During his admission, the patient was critically unwell and required surgical intervention and tracheostomy. However, he made a full recovery with no persisting morbidity. We believe that this was owed to the aggressive antimicrobial therapy, timely surgical management of the disease process and the patient’s immunocompetency.

Keywords: Ear nose and throat/otolaryngology; Infectious diseases; Otolaryngology / ENT.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Critical Illness
  • Debridement
  • Enterococcus faecalis / isolation & purification
  • Haemophilus Infections / complications
  • Haemophilus Infections / immunology
  • Haemophilus Infections / microbiology*
  • Haemophilus influenzae type b / isolation & purification
  • Humans
  • Immunocompetence / immunology
  • Influenza A virus / isolation & purification
  • Influenza, Human / complications
  • Influenza, Human / immunology
  • Influenza, Human / microbiology*
  • Male
  • Necrosis / immunology
  • Necrosis / microbiology*
  • Necrosis / pathology
  • Necrosis / therapy
  • Oseltamivir / therapeutic use*
  • Penicillin G / therapeutic use*
  • Supraglottitis / immunology
  • Supraglottitis / microbiology*
  • Supraglottitis / pathology
  • Supraglottitis / therapy
  • Tracheostomy*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Oseltamivir
  • Penicillin G