Quincke's Disease: isolated uvulitis.

A 27 year-old previously healthy man complained of sudden onset of gagging and foreign-body sensation that awoke him. He reported one day of nasal and sinus congestion. He had become concerned when he saw his extremely enlarged uvula while looking in a mirror (Figure). He had no fever, throat pain, or difficulty breathing, swallowing, or speaking. Prior to going to bed, he had taken an over-the-counter cold and allergy medication which he had taken previously without any adverse effects; he was not taking any other medications. He was admitted to the intensive care unit overnight for close observation and treated with nebulized racemic epinephrine, intravenous antihistamines and steroids. Empiric antibiotics directed against the most common infectious agents, Haemophilus and Streptococcus species were given.1 He had rapid improvement in his symptoms over the next 24 hours and was discharged home. Uvulitis can be caused by mechanical trauma, chemical or thermal injury, infection, or angioedema of immunologic or non-immunologic origin.2

Figure

Enlarged uvula.