Massive tongue edema from an allergic reaction to an antibiotic: epinephrine may avert need for endotracheal intubation

Massive tongue edema from allergic reaction to medications raises a serious concern for maintaining adequate respiration as well as establishing endotracheal intubation.  The necessity for airway intervention depends on the extent of airway edema, particularly the involvement to the laryngeal areas. Administration of subcutaneous epinephrine may rapidly decrease swelling of the tongue and may avert complications of airway intervention.