Acute Epiglottitis: Life-Threatening Airway Emergency, CT Diagnosis, Thumb Sign Radiology, and Evidence-Based Treatment
Abstract Acute Epiglottitis is a rapidly progressive, potentially fatal upper airway condition characterized by inflammation and edema of the epiglottis and surrounding supraglottic structures. Despite the widespread implementation of the Haemophilus influenzae type b (Hib) vaccine, epiglottitis remains clinically significant—particularly in adults—requiring prompt recognition and airway management. This column presents a radiology-driven case analysis, integrates CT imaging interpretation, and delivers a comprehensive expert-level review including pathophysiology, epidemiology, clinical presentation, imaging features, differential diagnosis, treatment strategies, and prognosis. Clinical Case Summary A 60-year-old male presented with: Severe sore throat (2 days) Hoarseness Fever Physical findings: No stridor, drooling, or respiratory distress Unremarkable oropharyngeal exam Radiologic findings: Lateral neck X-ray: “Thumb sign.” Contrast-enhanced CT: Enlarged, edematous epig...