Hospital Course:
The 28-year-old male patient presented to the outpatient department with a 3-day history of sore throat, vomiting, and fever. Upon arrival at 12:50 pm, he exhibited severe respiratory difficulty and stridor. Clinical examination revealed a severely congested throat with bilateral grade 2 tonsillar hypertrophy and follicles. Due to the emergent nature of the situation, an emergency tracheostomy was performed. Prior to the tracheostomy, the patient received immediate medical management, including intravenous administration of Ceftriaxone 1g BD, Metronidazole 500mg TDS, Dexamethasone 4mg OD, Omeprazole 40 mg OD, and Paracetamol 1g TDS.
Under aseptic measures, the patient was taken to the operating room. A tracheostomy was performed under local anesthesia- confirmed by an anesthesiologist. General anesthesia was administered, and a rigid direct laryngoscope was passed which revealed a swollen epiglottis(Figure 1A) . True and false vocal cords, bilateral arytenoids, and aryepiglottic folds were normal, and the subglottic region appeared normal. Bilateral pyriform was not visible due to swelling. The patient was handed over to the anesthesia department with oxygen saturation at 99%.