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%.