Emphysematous Epiglottitis in an Immunocompromised Adult with Unusual Pathogens: A Case-Based Literature Review

Emphysematous epiglottitis is a rare, potentially life-threatening complication of acute epiglottitis, characterized by gasforming infection of the epiglottis.While commonly associated with pediatric populations, epiglottitis can also occur in immunocompromised adults and may present atypically.We report a case of a 57-year-old man with poorly controlled Type 2 diabetes mellitus and end-stage renal failure who initially presented with typical symptoms of epiglottitis.Flexible laryngoscopy revealed a swollen epiglottis with overlying pustules.Computed tomography (CT) of the neck demonstrated gas loculi within the epiglottis, consistent with emphysematous transformation and abscess formation.The patient underwent urgent airway protection via fiber-optic intubation followed by incision and drainage of the abscess.Cultures yielded Streptococcus parasanguinis and Candida albicans.Following targeted antimicrobial therapy and corticosteroids, the patient made a full recovery.This case highlights the diagnostic value of CT in detecting emphysematous epiglottitis and emphasizes the need for radiologists to recognize this rare but emergent condition, particularly in high-risk patients.