Abstract

A 36-year-old man presented to the emergency department with 1 week of sore throat, odynophagia, change in voice and inability to swallow saliva. His oropharynx was unremarkable with no palpable cervical lymphadenopathy, but his anterior neck was tender to light palpation. Lateral cervical radiograph showed substantial epiglottal swelling manifesting as the ‘thumb sign’ (Figure 1). Bedside flexible nasal laryngoscopy revealed an erythematous edematous epiglottis, with preserved vocal cord structure and function. Acute infectious epiglottitis was diagnosed, and improved with intravenous antibiotics.

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