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[Epiglottitis in adults].

M Harell1, E Eviatar, H Flaksman

  • 1Dept. of Otolaryngology, Edith Wolfson Medical Center, Holon.

Harefuah
|September 1, 1990
PubMed
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Acute epiglottitis, though common in children, is increasingly seen in adults. This study highlights a delayed diagnosis in adult cases, emphasizing the need for prompt recognition and management of this emergency.

Area of Science:

  • Otolaryngology
  • Emergency Medicine
  • Infectious Diseases

Background:

  • Acute epiglottitis is a pediatric emergency with decreased mortality due to aggressive treatment.
  • Historically considered rare in adults, recent evidence suggests an increasing incidence in the adult population.
  • This study focuses on the presentation and management of acute epiglottitis in older patients.

Purpose of the Study:

  • To describe the clinical characteristics of acute epiglottitis in a cohort of adult patients.
  • To evaluate the diagnostic methods and treatment strategies employed in adult acute epiglottitis.
  • To identify potential challenges and outcomes associated with delayed diagnosis in this demographic.

Main Methods:

  • Retrospective analysis of 19 adult patients (aged 13-72 years) diagnosed with acute epiglottitis.

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  • Review of presenting symptoms, time to diagnosis, microbiological findings, and diagnostic imaging (indirect laryngoscopy, lateral neck X-ray).
  • Assessment of treatment protocols, including antibiotics, steroids, and airway management, and patient outcomes.

    • Main Results:

    • A significant delay in diagnosis was observed, averaging 2.5 days from symptom onset.
    • Common symptoms included severe sore throat and dysphagia; half of the patients experienced respiratory distress.
    • Indirect laryngoscopy and lateral neck X-rays were reliable diagnostic tools; conservative management was effective, with only one patient requiring intubation.

    Conclusions:

    • Acute epiglottitis occurs in adults and is often associated with a delay in diagnosis.
    • Prompt recognition of symptoms like severe sore throat and dysphagia is crucial for timely intervention.
    • Conservative management, including antibiotics and steroids, is often successful, with a low rate of airway compromise.