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Epiglottitis--an increasing problem for adults.

K H Sheikh, S R Mostow

    The Western Journal of Medicine
    |November 1, 1989
    PubMed
    Summary
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    Acute epiglottitis in adults is often misdiagnosed and requires prompt treatment. Early diagnosis and antibiotic therapy are crucial for recovery from this serious condition.

    Area of Science:

    • Otolaryngology
    • Infectious Diseases
    • Emergency Medicine

    Background:

    • Acute epiglottitis is a potentially life-threatening condition primarily affecting children, but also occurring in adults.
    • Diagnosis can be challenging, leading to delays in appropriate management and increased morbidity.

    Purpose of the Study:

    • To describe the clinical characteristics, diagnostic challenges, and management outcomes of adult acute epiglottitis.
    • To highlight the importance of early recognition and treatment in this patient population.

    Main Methods:

    • Retrospective review of 9 adult patients admitted with acute epiglottitis over a 2-year period.
    • Data collected included patient demographics, symptom duration, diagnostic methods (direct laryngoscopy, lateral neck radiograph), microbiological findings, and treatment outcomes.

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    Main Results:

    • The mean age of affected adults was 53 years, with a seasonal predilection from September to March (89%).
    • Four patients required intubation, with shorter symptom duration in intubated patients (7.8 hours) compared to non-intubated patients (18.8 hours).
    • Six patients (67%) received an incorrect initial diagnosis. Common pathogens included *Hemophilus influenzae* type b (4 patients) and *Streptococcus pneumoniae* (1 patient). Two cases of *H. influenzae* were ampicillin-resistant.

    Conclusions:

    • Adult acute epiglottitis presents with distinct epidemiological and clinical features, often with delayed diagnosis.
    • Prompt laryngoscopy, appropriate antibiotic therapy, and parenteral steroids are effective in managing acute epiglottitis and ensuring patient recovery.