Epiglottitis Strikes Twice: A Case of Adult Recurrent Epiglottitis

TL;DR

A 58-year-old man experienced a rare second episode of epiglottitis nine years after the first, with unclear immunological causes.

Contribution

This case report highlights the rarity of recurrent epiglottitis in adults and presents unique immunologic findings.

Findings

The patient had a significantly low CD4+ T lymphocyte count and IgG level during hospitalization.

The patient was successfully treated with broad-spectrum antibiotics and corticosteroids.

The underlying cause of the recurrent epiglottitis remains undetermined due to lack of further testing.

Abstract

Epiglottitis is an uncommon condition in adults, and recurrent episodes are rare. We report a 58-year-old male who had a second episode of epiglottitis nine years after his first. Our patient’s immunologic profile obtained during his hospitalization revealed a significantly low absolute cluster of differentiation 4+ (CD4+) T lymphocyte count of 77 cells/mcL and a low immunoglobulin G (IgG) level of 635 mg/dL. Our patient was successfully managed with broad-spectrum antibiotics and corticosteroids. Given the known ability of short-term corticosteroids and acute inflammation’s effect on lymphocyte populations, the significance of these laboratory values remains unclear due to our patient’s unwillingness to undergo further diagnostic testing following discharge from our facility. We have considered multiple underlying etiologies for our patient’s predisposition to developing this rare, recurrent, infectious manifestation; however, the exact cause is yet to be fully elucidated.

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