A one-year-old boy was rushed to the trauma room at Shaare Zedek Medical Center’s pediatric emergency department in critical condition, with a real and immediate threat to his life. Doctors initially suspected he had choked on a foreign object, based on what the father told Magen David Adom, but further examination showed a much more dangerous cause: epiglottitis, a rare and life-threatening inflammation of the epiglottis.
The child was found to be infected with Haemophilus influenzae type B, the bacterium that most commonly causes epiglottitis. Hospital staff later learned he had not received routine vaccinations, which likely prevented the disease. The diagnosis came after teams first checked the airway with a special endoscopic camera to look for a swallowed object, found no evidence of one, and then reassessed the situation as the swelling and edema worsened and threatened to block his airway.
Because the trachea was nearly closed off, anesthesiologists led by Dr. Mordechai Sherki and Dr. Shmuel Bashmut used an especially thin tube, normally used to ventilate premature newborns, to secure the airway. The rapid preparation and technical skill of the medical team saved the toddler from suffocation. He was treated by a multidisciplinary staff that included pediatricians, ENT doctors, anesthesiologists and additional nursing staff, then admitted to the pediatric intensive care unit under Dr. Jacques Brown before being transferred to the pediatric ward headed by Prof. Orly Magd.
Dr. Efrat Blankinstein said the child was “minutes from death” and that the case had not been seen at Shaare Zedek for decades. She added that it likely could have been prevented by vaccination and urged parents to immunize their children. Dr. Shani Masner Feierstein explained that epiglottitis has become much less common since Hib vaccination was added to routine immunizations, while Dr. Moriah Faizer-Rosenberg said the initial choking report turned out to be a completely different emergency once airway endoscopy showed no foreign body. Doctors said the outcome depended on the hospital being fully prepared and working together immediately upon arrival.
