Acute epiglottitis in adults is an uncommon but potentially life-threatening condition that can rapidly progress to airway compromise. Epiglottic abscess represents a rare and severe complication associated with increased morbidity and diagnostic challenges. We report a case of a 36-year-old male admitted to the emergency department in Belgium with progressive odynophagia, dysphonia, and hypersalivation despite prior oral antibiotic therapy. Laboratory investigations revealed a marked inflammatory response, including leukocytosis and elevated C-reactive protein. Contrast-enhanced computed tomography (CT) of the neck demonstrated a 30 mm epiglottic abscess extending toward the right tonsillar region, with associated mass effect on the supraglottic airway. The patient was admitted to the intensive care unit for close airway monitoring and was managed conservatively with intravenous antibiotics, corticosteroids, and supportive care. Despite the size of the abscess, no surgical intervention was required. The patient showed rapid clinical improvement, with complete resolution of symptoms and no airway compromise. This case highlights the importance of early imaging and vigilant airway assessment in adult epiglottitis. It also supports the role of conservative management in carefully selected, clinically stable patients with epiglottic abscess.
Wayne Eta (Sun,) studied this question.