(BMJ)—A 32-yo man presented w/ sudden-onset foreign body sensation in his throat that was assoc w/ drooling and muffled voice. He had eaten prawns the previous night and woke up w/ these sx. No pain, fever, trauma, or prior hx of allergy. Exam: enlarged uvula touching base of tongue; otherwise, unremarkable. What is the dx?
Epiglottitis
Peritonsillar abscess
Quincke dz
Lemierre syndrome
Ludwig angina
You are correct. Isolated uvular angioedema, or Quincke dz, is a rare presentation of angioneurotic edema affecting only the upper airway. Various etiologic factors (eg, food allergy, hereditary angioedema, inhalation exposure, drug rxns, trauma) have been implicated. Quincke dz should be differentiated from infectious uvulitis, which is generally assoc w/ tonsillitis, pharyngitis, and epiglottitis, causing pain and fever. This pt’s presentation was presumed to be due to an allergic rxn to prawns; he was treated w/ epinephrine, corticosteroids, and antihistamines. His uvular edema and sx resolved w/in 2h and he remained sx free 6mo later.

BMJ Case Reports CP 2019;12:e231967.