Spontaneous epiglottic abscess in an adult with undiagnosed diabetes

Introduction An epiglottic abscess is a life-threatening condition and can be formed after epiglottitis, sometimes potentiated by irradiation of the larynx, or iatrogenic. Certain comorbidities, such as immune suppression or diabetes, can facilitate spontaneous abscess formation.

We present a case of a, otherwise reported healthy person with a spontaneous epiglottic abscess in which we simultaneously found an uncontrolled, undiagnosed diabetesPatient/Methods We present a case of a 54-year-old male who reported no relevant medical history, with rapid progressive odynophagia and dyspnea, as well as endoscopic inflammation and focal edema of the epiglottis. A CT scan revealed signs of acute epiglottitis but showed no clear abscess formation. Upon admission to the hospital, high blood glucose levels were measured.

Result Because of high suspicion of abscess formation, an endoscopy in general anesthesia was performed and upon incision of the epiglottis, the diagnosis was confirmed. Due to excessive swelling of the larynx, extubation was impossible and a surgical tracheotomy was inevitable. His uncontrolled diabetes with an HbA1c of 13,2% resulted in a prolonged wound healing and prolonged need for tracheotomy.

Conclusion This case emphasizes the importance of an interdisciplinary patient approach and shows how a potentially life-threatening ENT condition can be the result of an underlying metabolic disease.

Publication History

Article published online:
12 May 2023