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Anesthesia Progress Jun 2020Epiglottitis is most commonly caused by bacterial infection resulting in inflammation and edema of the epiglottis and neighboring supraglottic structures. Acute...
Epiglottitis is most commonly caused by bacterial infection resulting in inflammation and edema of the epiglottis and neighboring supraglottic structures. Acute infection was once found predominantly in children ages 2 to 6 years old, but with the introduction of the Haemophilus influenzae B (HiB) vaccine the incidence of cases in adults is increasing. Typical clinical presentation of epiglottitis includes fever and sore throat. Evidence of impending airway obstruction may be demonstrated by muffled voice, drooling, tripod position, and stridor. Radiographs can be helpful in diagnosing epiglottitis; however, they should not supersede or postpone securing the airway. An airway specialist such as an otolaryngologist, anesthesiologist, or intensivist should ideally evaluate the patient immediately to give ample time for preparing to secure the airway if necessary. All patients with epiglottitis should be admitted to the intensive care unit for close monitoring.
Topics: Adult; Child; Child, Preschool; Epiglottis; Epiglottitis; Humans
PubMed: 32633776
DOI: 10.2344/anpr-66-04-08 -
Tidsskrift For Den Norske Laegeforening... Sep 2020Acute epiglottitis in adults is a rare, potentially life-threatening condition caused by a bacterial infection in the epiglottis. Typical symptoms are fever, sore...
BACKGROUND
Acute epiglottitis in adults is a rare, potentially life-threatening condition caused by a bacterial infection in the epiglottis. Typical symptoms are fever, sore throat, and respiratory distress caused by upper airway obstruction. Proper treatment is needed for a good outcome.
CASE PRESENTATION
We here present a 54-year-old female patient with acute epiglottitis. Her airway was secured by endotracheal intubation and she received antimicrobial therapy. She developed an abscess around the epiglottis that needed surgical drainage and tracheotomy. However, she fully recovered after nine days in hospital.
INTERPRETATION
Acute epiglottitis in adults is a potentially life-threatening condition. The prognosis is good with proper treatment including selective airway intervention, antimicrobial therapy, and close monitoring.
Topics: Acute Disease; Adult; Epiglottis; Epiglottitis; Female; Humans; Intubation, Intratracheal; Middle Aged; Pharyngitis
PubMed: 32998500
DOI: 10.4045/tidsskr.20.0382 -
Infectious Disease Clinics of North... Jun 2007Acute pharyngitis is one of the most common illnesses for which patients visit primary care physicians. Most cases are of viral origin, and with few exceptions these... (Review)
Review
Acute pharyngitis is one of the most common illnesses for which patients visit primary care physicians. Most cases are of viral origin, and with few exceptions these illnesses are both benign and self-limited. The most important bacterial cause is the beta-hemolytic group A streptococcus. There are other uncommon or rare types of pharyngitis. For some of these treatment is required or available, and some may be life threatening. Among those discussed in this article are diphtheria, gonorrhea, HIV infection, peritonsillar abscess, and epiglottitis.
Topics: Epiglottitis; Humans; Pharyngitis
PubMed: 17561078
DOI: 10.1016/j.idc.2007.03.001 -
European Annals of Otorhinolaryngology,... Mar 2021Apart from cases related to direct inoculation, pasteurellosis is a rare opportunistic infection occurring in predisposed subjects. Close contact with domestic animals,...
INTRODUCTION
Apart from cases related to direct inoculation, pasteurellosis is a rare opportunistic infection occurring in predisposed subjects. Close contact with domestic animals, usually cats, is generally reported. Localized ENT forms are possible and are due to oropharyngeal carriage.
CASE REPORT
We present the case of a patient with no notable history, who presented with laryngeal dyspnea and hyperthermia leading to a diagnosis of acute epiglottitis. Bacteremia was detected and blood cultures were positive for Pasteurella multocida. Treatment consisted of the standard treatment for acute epiglottitis with hospitalisation and intravenous antibiotics.
DISCUSSION
This patient presented a history of animal exposure, but no other known risk factors. The activity spectrum of antibiotic therapy for epiglottitis should include H. influenzae and this case illustrates the diversity of the micro-organisms potentially involved. Immunosuppression or another chronic disease does not appear to be a prerequisite for ENT infection.
Topics: Animals; Anti-Bacterial Agents; Bacteremia; Cats; Epiglottitis; Humans; Pasteurella Infections; Pasteurella multocida
PubMed: 32600824
DOI: 10.1016/j.anorl.2020.06.008 -
European Annals of Otorhinolaryngology,... May 2021
Topics: Epiglottis; Granuloma; Humans
PubMed: 33069596
DOI: 10.1016/j.anorl.2020.06.027 -
Ear, Nose, & Throat Journal Sep 2021
Topics: Aged; Cysts; Epiglottis; Epiglottitis; Humans; Laryngeal Diseases; Laryngeal Muscles; Larynx; Male; Medical Illustration
PubMed: 32133889
DOI: 10.1177/0145561320910676 -
Critical Care Clinics Jul 2000Airway management in the pediatric patient requires an understanding and knowledge of the differences and characteristics unique to the child and infant. New and... (Review)
Review
Airway management in the pediatric patient requires an understanding and knowledge of the differences and characteristics unique to the child and infant. New and exciting techniques are currently being explored and developed for management of the pediatric airway. Technology in the area of imaging has allowed clinicians to better visualize the airway and aberrations of it. Presently, there are many different modes and routes of ventilation and oxygenation that are being applied to the pediatric patient for different disease states. Work continues to probe for methods and ways that will allow us to take care of infants and children better and to provide the safest and most effective means of delivering that care. No doubt, there will be more advances and exciting ideas to come that lead to better management of the pediatric airway.
Topics: Age Factors; Airway Obstruction; Algorithms; Body Weight; Burns, Inhalation; Child; Child, Preschool; Croup; Decision Trees; Epiglottitis; Equipment Design; Humans; Infant; Infant, Newborn; Intubation, Intratracheal; Laryngeal Masks; Pediatrics; Radiography; Resuscitation
PubMed: 10941587
DOI: 10.1016/s0749-0704(05)70126-3 -
European Annals of Otorhinolaryngology,... Oct 2021To identify contributive criteria in decision-making for intubation in acute epiglottitis, based on clinical and endoscopic data in adult patients, and to study clinical...
OBJECTIVES
To identify contributive criteria in decision-making for intubation in acute epiglottitis, based on clinical and endoscopic data in adult patients, and to study clinical and biological characteristics and management.
MATERIALS AND METHODS
Diagnosis was established by flexible endoscopy showing epiglottic edema in association with general signs of sepsis in 28 patients consulting into two French hospitals between 2005 and 2016. Retrospective univariate and multivariate analysis between patients managed by intubation (Group I) or surveillance (Group S) was performed on clinical and endoscopic data.
RESULTS
Ten patients were intubated (36%). On univariate analysis, 4 variables were suggestively associated with intubation. On multivariate analysis, associations remained suggestive for dyspnea (OR=50.6; 95% CI=[2.7; 940.1]) and supraglottic edema extension (OR=42.2; 95% CI=[2.2; 799.5]). The area under the curve identifying intubated patients on these 2 criteria was 90.8%, testifying to high discrimination.
CONCLUSION
Intubation must always be considered in epiglottitis. Dyspnea and supraglottic extension of the edema seem to be the two main criteria to be considered in airway control decision-making.
Topics: Acute Disease; Adult; Dyspnea; Epiglottitis; Humans; Intubation, Intratracheal; Retrospective Studies
PubMed: 33358682
DOI: 10.1016/j.anorl.2020.12.001 -
California Medicine May 1960Although acute epiglottitis is not a rare disease and may be very severe or fatal, it is one not familiar, as it should be, to all physicians dealing with children....
Although acute epiglottitis is not a rare disease and may be very severe or fatal, it is one not familiar, as it should be, to all physicians dealing with children. Diagnosis may be confirmed clinically by direct or indirect examination of the epiglottis. Vaporized cool water is preferable to steam for reducing the swelling of mucosal tissues that impairs breathing. Chloramphenicol is the drug of choice, as the majority of cases of acute epiglottitis are due to H. Influenzae. Tracheotomy must be carried out if necessary to maintain an airway.
Topics: Acute Disease; Child; Chloramphenicol; Choice Behavior; Disease; Epiglottis; Epiglottitis; Humans; Influenza, Human; Maintenance; Nebulizers and Vaporizers; Physicians; Rare Diseases; Respiration; Steam; Tracheotomy; Water
PubMed: 13849026
DOI: No ID Found -
The Western Journal of Medicine Mar 1977Treatment techniques for airway obstruction in croup and epiglottitis are reviewed in the medical literature. Series totaling 295 nasotracheal intubations, and 591... (Review)
Review
Treatment techniques for airway obstruction in croup and epiglottitis are reviewed in the medical literature. Series totaling 295 nasotracheal intubations, and 591 tracheostomies were reviewed. There were two deaths attributable to airway complications in 126 patients in whom nasotracheal intubation was carried out. In three patients subglottic granulation tissue and subglottic stenoses developed from short-term nasotracheal intubation. There were no subglottic stenoses or tracheal stenoses reported in the 591 tracheostomies. From this review, it would seem feasible to use nasotracheal intubation for short-term airway treatment in croup and epiglottitis. The increasing occurrence of laryngeal and tracheal complications with long-term intubation suggests that tracheostomy be considered in such cases.
Topics: Airway Obstruction; Croup; Epiglottis; Humans; Intubation, Intratracheal; Laryngitis; Time Factors; Tracheotomy
PubMed: 349884
DOI: No ID Found