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Pediatric thermal epiglottitis: insights from a tertiary center experience

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Abstract

Thermal epiglottitis, a non-infectious cause of epiglottitis, is a rare entity that shares some clinical features with infectious epiglottitis. This study presents 16 years of experience in diagnosing and managing thermal epiglottitis. A retrospective descriptive study in a tertiary center in southern Israel included confirmed cases of thermal epiglottitis in children (0–18 years) between 2004 and 2020 by endoscopy. Of approximately 600,000 pediatric ER admissions between 2004 and 2020, seven children were diagnosed by endoscopy with thermal epiglottitis (mean age 24 months, 71% males). Clinical presentation included stridor, respiratory distress, and drooling. Four children had fever and elevated inflammatory markers at presentation and were treated with systemic antibiotics. All were treated with systemic steroids. The median length of stay in the PICU was five days, and four patients required intubations. All fully recovered without experiencing any sequelae.

  Conclusion: Thermal epiglottitis stands as a potential contributor to acute upper airway obstruction. Although it’s rarity, it should be discussed in any child with acute upper airway obstruction. It is essential to inquire directly about the accidental intake of hot beverages, particularly in cases lacking fever or elevated inflammatory markers.

What is Known:

• Thermal epiglottitis is a rare, non-infectious condition sharing clinical features with infectious epiglottitis.

• Common presentations include stridor, respiratory distress, and drooling.

What is New:

• Thermal epiglottitis is a potential contributor to acute upper airway obstruction, urging consideration even in the absence of fever or elevated markers.

• Direct inquiry about hot beverage intake for diagnosis is essential for diagnosis.

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Data availability

No datasets were generated or analysed during the current study.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Leonel Slanovic MD, Dr. Noga Arwas MD, Inbal Golan-Tripto MD and Eitan Neeman MD contributed equally to this work.

Authors and Affiliations

  1. Pediatric Cardiology Unit, Soroka University Medical Center, Beer-Sheva, Israel

    Leonel Slanovic

  2. Pediatric Pulmonary Unit, Soroka University Medical Center, Beer-Sheva, Israel

    Noga Arwas, Dvir Gatt, Aviv Goldbart, Soliman Alkrinawi & Inbal Golan-Tripto

  3. Pediatric Intensive Care Unit, Soroka University Medical Center, Beer-Sheva, Israel

    Isaac Lazar, Yael Feinstein & Eitan Neeman

  4. Department of ENT Surgery, Soroka University Medical Center, Beer-Sheva, Israel

    Daniel Yafit

  5. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Noga Arwas, Micha Aviram, Dvir Gatt, Aviv Goldbart & Inbal Golan-Tripto

  6. Pediatric Pulmonary Unit, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University, PO box 151, Beer Sheva, Israel

    Noga Arwas

Authors
  1. Leonel Slanovic
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Leonel Slanovic and Noga Arwas. The first draft of the manuscript was written by Noga Arwas, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Noga Arwas.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Soroka University Medical Center.

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The authors declare no competing interests.

Additional information

Communicated by Peter de Winter

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In memory of Dr. Eitan Neeman, whose invaluable contributions to this manuscript and his passion for advancing medical knowledge continue to inspire us.

Electronic supplementary material

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Supplementary Material 1 Table 1: Clinical presentation and follow-up findings. Video 1: Endoscopy showing Epiglottis edema and arytenoids with 426 white coating.

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Slanovic, L., Arwas, N., Aviram, M. et al. Pediatric thermal epiglottitis: insights from a tertiary center experience. Eur J Pediatr (2024). https://doi.org/10.1007/s00431-024-05555-x

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