[Acute epiglottitis in Iceland from 1983-2005].

Abstract:

OBJECTIVE:To describe the changes in the epidemiology of acute epiglottitis in Iceland from 1983-2005. METHODS:All patients with discharge diagnosis of epiglottitis during the study years were identified and diagnosis confirmed by chart review. Main outcome measures were age, gender, month/year of diagnosis, microbiology, airway management, ICU admissions, choice of antibiotics, length of hospital stay and major complications/mortality. RESULTS:Fifty-seven patients were identified (annual incidence 0.93/100.000). The mean age was 33.3 years (1-82). Childhood epiglottitis disappeared after introduction of Haemophilus influenzae type b (Hib) vaccination in 1989 but adult disease showed non-significant increase. In the pre-vaccination era Hib was the most common organism cultured but it has not been diagnosed in Iceland since 1991 and Streptococci are now the leading cause of epiglottitis. The mean hospital stay was 5.05 nights with 51% of patients admitted to ICU. All children under 10 years and a total 30% of patients received airway intervention. Ninety percent of adults were observed without airway intervention. Major complications were rare and mortality was 0% in our series. CONCLUSION:There have been major changes in the epidemiology of epiglottitis in Iceland during the study period. Previously a childhood disease, epiglottitis has disappeared in children and is now almost exclusively found in adults. This can be attributed to widespread Hib vaccination, eliminating the major causative agent in children. The treatment of this life-threatening disease remains a challenge. Our series suggest that it is safe to observe patients with mild/moderate symptoms without airway intervention.

journal_name

Laeknabladid

journal_title

Laeknabladid

authors

Briem B,Thorvardarson O,Petersen H

doi

10.17992/lbl.2010.06.300

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

405-11

issue

6

eissn

0023-7213

issn

1670-4959

journal_volume

96

pub_type

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