Beware of thermal epiglottis! A case report describing 'teapot syndrome'

BMC Anesthesiol. 2018 Dec 22;18(1):203. doi: 10.1186/s12871-018-0665-7.

Abstract

Background: The type of scalding injury known as 'teapot syndrome', where hot liquid is grabbed by the child with the aim of ingestion and falls over a child causing burns on the face, upper thorax and arms, is known to cause peri-oral and facial oedema. Thermal epiglottitis following scalds to face, neck and thorax is rare and can occur even in absence of ingestion of a damaging agent or intraoral burns, Awareness of the possibility of thermal epiglottitis, also in scald burns, is imperative to ensure prompt airway protection.

Case presentation: We report the case of a child with thermal epiglottitis after a scalding burn from boiling milk resulting in mixed deep burns of the face, neck and chest, but no history of ingestion. Upon presentation there was a progressive stridor and signs of respiratory distress requiring intubation. Laryngoscopy revealed epiglottis oedema, confirming the diagnosis of thermal epiglottitis. Final extubation took place 5 days after initial burn.

Conclusions: Thermal epiglottitis following scalds to face, neck and thorax is rare and can occur even in absence of ingestion and intra-oral damage. Burns to the peri-oral area should raise suspicion of additional damage to oral cavity and supraglottic structures, even in absence of intra-oral injury or initial respiratory distress. Awareness of the occurrence of thermal epiglottitis in absence of intra-oral injury is important to diagnose impending upper airway obstruction requiring intubation.

Keywords: Airway injury; Burn injury; Thermal epiglottitis.

Publication types

  • Case Reports

MeSH terms

  • Burns / complications
  • Burns / diagnosis*
  • Epiglottis / pathology*
  • Epiglottitis / diagnosis*
  • Epiglottitis / etiology
  • Humans
  • Infant
  • Laryngoscopy / methods*
  • Male
  • Respiration Disorders / etiology