Which organism is most commonly associated with epiglottitis?

• A. Parainfluenza
• B. Influenza A
• C. Adenovirus
• D. Hemophilus influenzae

Answer: (D)

Haemophilus influenzae type B is the classic cause of epiglottitis in children. Historically, Hib was the most common bacterial agent producing acute swelling of the epiglottis with rapid airway compromise. Vaccination against Hib has greatly reduced this incidence, but the association remains a foundational point and is still tested.

Other options are more characteristic of different airway illnesses. Parainfluenza viruses are the usual culprits of croup, which presents with a barking cough and inspiratory stridor rather than a swollen epiglottis. Influenza A causes flu-like illness with systemic symptoms, not the typical epiglottitis picture. Adenovirus can cause pharyngitis and conjunctivitis and occasionally airway symptoms, but it is not the prototypical cause of epiglottitis.

In clinical practice, suspected epiglottitis requires careful airway management and empiric antibiotics that cover Hib (for example, a third-generation cephalosporin), keeping in mind Hib vaccination status has lessened but not eliminated this association.