Introduction: Paediatric acute epiglottitis is rare in Asia. The National University Hospital in Singapore has seen only two cases of paediatric acute epiglottitis in the last 10 years. The topic is re-visited here to remind physicians of its acutely dramatic progression.
Clinical picture: Both boys presented with a viral prodrome which progressed within hours to life-threatening upper airway obstruction. Examination revealed an inflamed epiglottitis.
Treatment: They were successfully intubated and treated with intravenous antibiotics.
Outcome: Both recovered uneventfully.
Conclusion: Paediatric acute epiglottitis has declined markedly in the West with widespread vaccination against HiB. In contrast, the incidence of invasive HiB disease in Asia has always been low despite limited vaccination. Clinicians must remain vigilant of the possibility of acute epiglottitis in a child with "flu".