Epiglottitis in four – year- old boy caused by COVID-19 infection

Abstract

Introduction: Epiglottitis is an inflammatory disease involving the epiglottis, vallecula, aritenoid cartilage, and aryepiglottic wrinkles. Acute epiglottitis is relatively rare but can quickly lead to life-threatening airway obstruction. Diagnosis of epiglottitis is clinical, but radiography and direct vision of the epiglottis can also help with the diagnosis. Clinical manifestations of epiglottitis include fever, sore throat, and in the event of imminent airway obstruction, also may present with muffled sound, falls, tripod position, and stridor. Epiglottitis can be caused by some bacterial agents or viruses such as adenovirus and measles.COVID-19 was first detected in December 2019 in a group of patients with severe respiratory symptoms in Hubei Province, China. Common symptoms include fever, cough, fatigue, difficulty breathing, and loss of smell and taste. Although COVID-19 disease has a variety of manifestations, only one case of epiglottitis following COVID-19 disease has been reported in adults. Case presentation: The patient, a 4-year-old boy, came to our center and the patient's family complained of shortness of breath and progressive lethargy of the child 10 days ago. Since last week, he has been sleeping in a sitting position due to the aggravation of shortness of breath. On physical examination, respiratory distress, tachypnea, subcostal retraction, tail stridor, and crackle was heard in both lungs. Diagnosed with suspected bronchoscopy epiglottitis, a large, swollen, and cherry-red epiglottis was observed. Based on the patient's history of respiratory symptoms and the prevalence of COVID-19, a reverse pharyngeal polymerase (RT-PCR) transcript test was requested for COVID-19 and the COVID-19 infection was positive. Conclusion: In this article, we reported an 4-year-old child with epiglottitis in the context of COVID19.