(Figure 1A - Imagine captured through video-laryngoscope post-tracheostomy)
Per-operative findings during emergency tracheostomy followed by direct laryngoscopy revealed a significantly enlarged epiglottis(Figure 1A) , providing insight into the cause of the severe congestion observed during clinical examination. Hypertrophy of the epiglottis confirmed the diagnosis of acute epiglottitis.
Laboratory investigations were undertaken to elucidate the diagnosis and to understand the extent of the infection. A complete blood count (CBC) was performed, and the results are depicted in Table 1 . The CBC revealed an elevated Total Leukocyte Count (TLC) indicating a pronounced systemic response to infection. This marked leukocytosis is often associated with bacterial infections and was suggestive of a severe infectious process, corroborating the clinical suspicion of acute epiglottitis. Further differentiation of the leukocyte profile, as detailed in Table 2, showed a disproportionately high neutrophil percentage of 92%. This neutrophilia is a hallmark of an acute bacterial infection, providing further evidence to support the infectious etiology of the patient’s epiglottitis. The differential count, in conjunction with the elevated TLC, Highlights the body’s robust immunological response to the pathogenic insult.
These finding, combined with the comprehensive medical regimen administered pre-tracheostomy contributed to the successful emergency management of the patient’s condition.
The patient was admitted to for close medical surveillance and management. Serial laboratory investigations were integral to monitoring the patient’s progress. Tables 1 and 2 illustrate the trajectory of the Total Leukocyte Count (TLC) and the differential leukocyte percentages across multiple time points.
A consistent decline in TLC was observed, indicating a favorable response to the instituted medical regimen. Concurrently, there was a noted decrease in neutrophil percentage, which further suggested a resolution of the acute inflammatory state. These laboratory trends were not only prognostic but also guided the clinical decisions regarding the intensity of medical therapy and infection control measures.
The patient’s clinical course, characterized by stabilization in vital signs and symptomatic relief, mirrored the improvements seen in the laboratory parameters. This congruence was indicative of a successful post-operative recovery and an effective response to the medical treatment.