• Guanghua Fu, Luyao Yang, and Guisheng Wu.
• Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng, Shandong, China.
• Medicine (Baltimore). 2024 Jun 21; 103 (25): e38658e38658.

IntroductionAcute epiglottitis is not uncommon and it can cause high mortality due to airway obstruction. Acute epiglottitis complicated with cervical necrotizing fasciitis has rarely been reported, and it is also a life-threatening disease with a fatality rate of 7% to 50%.Patient ConcernsA 64-year-old woman presented to our hospital with chief complaints of sore throat and cervical swelling, long with foreign body sensation and hoarseness. Endoscopic laryngoscopy showed erythematous and swollen epiglottis with purulent secretions on the surface. Computed tomography (CT) scan showed swollen epiglottis and swelling of the neck with air- and fluid-containing necrotizing tissue.DiagnosesThe diagnosis was acute epiglottitis and abscess complicated with cervical necrotizing fasciitis.InterventionsWith the patient in awake condition, airway access was established by performing intubation with adjunctive use of gum elastic bougie, followed by surgical debridement under general anesthesia; a flap was used for skin coverage and intravenous piperacillin-tazobactam was administered.OutcomesThe patient was discharged without complications.ConclusionGum elastic bougie is a usable tool in difficult intubation. Adequate pre-anesthesia evaluation, patient sedation, and gentle manipulation assured the intubation success in this case.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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