BMJ Case Reports 2017; doi:10.1136/bcr-2017-219631
  • Rare disease

Multipathogenic necrotising supraglottitis in an immunocompetent patient

  1. Mriganka De
  1. Otorhinolaryngology, Head and Neck Surgery, Royal Derby Hospital, Derby, UK
  1. Correspondence to Mr James Douglas Constable, james.constable{at}
  • Accepted 30 May 2017
  • Published 18 June 2017


Supraglottitis is a potentially life-threatening condition. It is now uncommon due to the Haemophilus influenzae type B vaccination and is more recently caused by Streptococcus pneumoniae, S. pyogenes, H. influenzae non-type B, H. parainfluenzae, Staphylococcus aureus and Pasteurella multocida. Very rarely, it can cause necrotising supraglottitis/epiglottitis, and this has been reported in immunocompromised individuals. We present a unique case of multipathogenic supraglottitis causing laryngeal fibrinoid necrosis in an immunocompetent patient. During his admission, the patient was critically unwell and required surgical intervention and tracheostomy. However, he made a full recovery with no persisting morbidity. We believe that this was owed to the aggressive antimicrobial therapy, timely surgical management of the disease process and the patient’s immunocompetency.


  • Contributors TK and MD: identification of case and significant contributions to discussion and conclusions. JDC: completed literature review, contributed to discussion and conclusions and formatted manuscript. JJA: lead author; lead the contributions to all sections and collected images for figures.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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