Case report: Epiglottitis in the setting of COVID-19.

Epiglottitis is an uncommon, potentially fatal infection of the epiglottis that can lead to complete upper airway obstruction. Isolated pathogens are usually nasopharyngeal bacteria, most commonly Haemophilus influenzae type b (Hib). While the incidence of epiglottitis has diminished significantly over the years due to widespread vaccination against Hib, the proportion of epiglottitis caused by other pathogens has increased. In this report, we introduce an unseen presentation of acute epiglottitis associated with severe acute respiratory distress syndrome--coronavirus2 (SARS-CoV-2), who presented to the emergency department with throat pain and odynophagia that quickly resulted in respiratory distress. Clinicians should be aware of airway edema's concomitant presence in patients with acute epiglottitis and COVID-19 and maintain a low threshold for intubation. The rapidly progressive nature of COVID-19 and its complications may preclude intubation later on in the patient's clinical course, potentially necessitating an emergent surgical airway.

A Curious Case of MRSA Bacteremia and Septic Pulmonary Embolism Secondary to Peripheral Venous Catheter.

BACKGROUND: Central venous catheters (CVCs) have been frequently associated with septic thrombophlebitis, bacteremia, and septic emboli. Right-sided infective endocarditis is seen concurrently in patients with septic pulmonary emboli. A case of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and septic pulmonary emboli secondary to infected peripheral venous catheter (PVC) is reported. Transesophageal echocardiogram (TEE) showed no evidence of infective endocarditis. Case Presentation. A 44-year-old female presented to E.R. with left upper extremity pain and swelling at the previously inserted peripheral 18-gauge intravenous catheter site. She also had chest pain, which worsened with inspiration. The patient was found to be in septic shock. Her clinical condition deteriorated acutely. Right upper extremity deep venous thrombosis (DVT) and pulmonary emboli were seen on imaging. Blood cultures grew MRSA. Transthoracic and transesophageal echocardiograms showed no vegetations. The patient responded well to appropriate antibiotics and anticoagulation. CONCLUSION: Peripherally inserted catheters are an important portal for pathogen entry and need periodic site assessment and frequent evaluation of their need for insertion. Septic pulmonary emboli can also be seen without any evidence of right-sided infective endocarditis.