(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.