Acute epiglottitis in adults: a potentially lethal cause of sore throat

The diagnosis, management and outcome in 12 adults with acute epiglottitis was reviewed. Painful dysphagia was a universal symptom and respiratory distress affected eight patients, six of whom required urgent airway intervention. All patients received parenteral antibiotics, ten received steroids and four received adrenaline. Respiratory distress resolved in two patients given adrenaline and airway intervention was avoided. Indirect laryngoscopy is the investigation of choice and this is preferable to neck radiology. Two patients died and it is stressed that this condition must be distinguished from other more common causes of a severe sore throat. The patient should be managed in a unit with the facilities and expertise to effect acute airway intervention.