Epiglotitis
H influenzae type B is becoming a less common cause of epiglottis with vaccination.
Epiglotitis is an upper airway emergency.
Epidemiology is shifting away from H influenzae type B with vaccination. Other strains of H influenza, Streptococcus pneumoniae, β-hemolytic streptococci, and Staphylococcus aureus are potential pathogens in a vaccinated child.
Ceftriaxone or cefotaxime are first line therapies. Some reference recommend addition of anti-staphylococcal agent. Nelsons recommends consideration of addition of Clindamycin for MRSA coverage citing a 5% rate of staphylococcal infection. UptoDate recommend routine addition of anti-staphylococcal coverage with agent depending on local susceptibility patterns.
References
Gorga SM, Gilsdorf JR, Mychaliska KP. Haemophilus influenzae Serotype f Epiglottitis: A Case Report and Review. Hosp Pediatr. 2017 Jan;7(1):54-56. PMID: 28028010
Bradly JS (ed.) (2018) Nelson's Pediatric Antimicrobial Therapy 24th edition. Itasca, IL:American Academy of Pediatrics