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Paediatric acute epiglottitis re-visited.

Y M Low1, J L Leong, H K K Tan

  • 1Department of Otolaryngology, Singapore General Hospital, Outram Road, Singapore 169608. enttankk@kkh.com.sg

Singapore Medical Journal
|March 17, 2004
PubMed
Summary
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Paediatric acute epiglottitis, a rare condition, can rapidly progress to life-threatening airway obstruction. Vigilance is crucial, as symptoms may mimic the flu, necessitating prompt medical attention.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Otolaryngology

Background:

  • Paediatric acute epiglottitis is a rare condition globally, with limited incidence reported in Asia.
  • The National University Hospital in Singapore documented only two cases in the past decade.
  • This highlights the need to maintain physician awareness of this critical illness.

Observation:

  • Two paediatric cases presented with a viral prodrome.
  • Symptoms rapidly evolved to severe upper airway obstruction within hours.
  • Clinical examination revealed characteristic inflamed epiglottitis.

Findings:

  • Both patients required successful endotracheal intubation.
  • Intravenous antibiotic treatment was administered.
  • Both children experienced an uneventful recovery.

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Implications:

  • Widespread Haemophilus influenzae type b (Hib) vaccination has reduced epiglottitis in the West.
  • Asia has historically low invasive Hib disease incidence, even with limited vaccination.
  • Clinicians must remain vigilant for acute epiglottitis in children presenting with flu-like symptoms.