Acute epiglottitis in adults: the Royal Melbourne Hospital experience.

Abstract:

BACKGROUND:To examine the common presentations and management of acute epiglottitis in adults. METHOD:Retrospective clinical study of 17 consecutive adult patients who presented to the Royal Melbourne Hospital between January 1988 and December 2000 was undertaken. RESULTS:The mean patient age was 47 years (range 20-87 years) and the male-to-female ratio was 1.8 : 1.0. Peak incidence occurred in September during early spring. All patients presented with sore throat and dysphagia; however, respiratory distress was only noted in 65%. The most common signs were temperature and tachycardia. Four patients (23%) required endotracheal intubation, which was performed electively in three and as an emergency in one. Three of 14 blood cultures were positive, two yielded Haemophilus influenzae type b and one yielded Streptococcus mitis. One of the four throat cultures was positive for Haemophilus influenzae type b. Twelve patients underwent awake flexible laryngoscopy under topical anaesthetic as part of their initial assessment, and there were no complications associated with this procedure. There was no mortality. CONCLUSIONS:The diagnosis of acute epiglottitis in the adult population is difficult as respiratory distress may be absent. Patients who have a significant sore throat with no obvious aetiology should have direct visualization of their larynx by flexible laryngoscopy. Lateral X-ray of neck is of limited value. Once diagnosed, these patients should be hospitalized and monitored as airway obstruction may develop rapidly.

journal_name

ANZ J Surg

journal_title

ANZ journal of surgery

authors

Wong EY,Berkowitz RG

doi

10.1046/j.1445-1433.2001.02265.x

keywords:

subject

Has Abstract

pub_date

2001-12-01 00:00:00

pages

740-3

issue

12

eissn

1445-1433

issn

1445-2197

pii

2265

journal_volume

71

pub_type

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